357 results on '"stent restenosis"'
Search Results
2. IVL vs ELCA for Stent Underexpantsion (IVL-ELCA DRAGON) (DRAGON)
- Author
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Wojciech Wańha, MD, PhD, Prof. Ass.
- Published
- 2024
3. Gene’s Association with Coronary Stent Stenosis After Drug Eluting Stent: Review
- Author
-
Elmansouri, Rajaa, Tazzite, Amal, Dehbi, Hind, Habbal, Rachida, Kacprzyk, Janusz, Series Editor, Gomide, Fernando, Advisory Editor, Kaynak, Okyay, Advisory Editor, Liu, Derong, Advisory Editor, Pedrycz, Witold, Advisory Editor, Polycarpou, Marios M., Advisory Editor, Rudas, Imre J., Advisory Editor, Wang, Jun, Advisory Editor, Ezziyyani, Mostafa, editor, and Balas, Valentina Emilia, editor
- Published
- 2024
- Full Text
- View/download PDF
4. Gene’s Association with Coronary Stent Stenosis After Drug Eluting Stent: Mini-review
- Author
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Elmansouri, Rajaa, Tazzite, Amal, Dehbi, Hind, Habbal, Rachida, Kacprzyk, Janusz, Series Editor, Gomide, Fernando, Advisory Editor, Kaynak, Okyay, Advisory Editor, Liu, Derong, Advisory Editor, Pedrycz, Witold, Advisory Editor, Polycarpou, Marios M., Advisory Editor, Rudas, Imre J., Advisory Editor, Wang, Jun, Advisory Editor, Ezziyyani, Mostafa, editor, and Balas, Valentina Emilia, editor
- Published
- 2024
- Full Text
- View/download PDF
5. Registry of Secondary Revascularization (REVASEC)
- Author
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Laboratorios Farmacéuticos Rovi, S.A., S&H MEDICAL SCIENCE SERVICE, S.L., and Pablo Salinas, MD
- Published
- 2023
6. Clinical Study of Tongxinluo Capsule in Preventing and Treating Restenosis After Intracranial and External Arterial Stenting
- Author
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Yanbin Li, Professor
- Published
- 2023
7. A systematic review and bioinformatic study on clinical, paraclinical, and genetic factors predisposing to stent restenosis following percutaneous coronary intervention
- Author
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Farzad Shahsanaei, Abdullah Gharibzadeh, Soudabeh Behrooj, Shahin Abbaszadeh, and Mahboobeh Nourmohammadi
- Subjects
Stent restenosis ,ACS ,PCI ,Bioinformatic ,Genes ,MicroRNA ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis. Main text In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis. Conclusions The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions.
- Published
- 2024
- Full Text
- View/download PDF
8. A systematic review and bioinformatic study on clinical, paraclinical, and genetic factors predisposing to stent restenosis following percutaneous coronary intervention.
- Author
-
Shahsanaei, Farzad, Gharibzadeh, Abdullah, Behrooj, Soudabeh, Abbaszadeh, Shahin, and Nourmohammadi, Mahboobeh
- Subjects
PERCUTANEOUS coronary intervention ,LITERATURE reviews ,GENE ontology ,MYOCARDIAL infarction ,CORONARY disease ,CARDIAC patients - Abstract
Background: Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis. Main text: In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis. Conclusions: The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. Proximal superficial femoral artery puncture using an ascending approach for stent re-occlusion in the common femoral artery.
- Author
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Okabe, Hiroki, Doi, Hideki, Umeda, Miyu, Takeo, Masahiro, Nakamura, Yuki, Motozato, Kota, Furukawa, Shotaro, Kawakami, Kazunobu, Abe, Koji, Matsumura, Toshiyuki, and Kataoka, Masaharu
- Abstract
We aimed to describe a technique for approaching the common femoral artery (CFA) in cases where doing so is difficult owing to an occluded lesion caused by a previously implanted stent. A 72-year-old woman had severe stenotic lesions in both iliac arteries that required an approach via the bilateral femoral arteries. The right CFA had a previously implanted stent and a completely occluded lesion that extended from the superficial femoral artery (SFA). A 20G needle was inserted through the proximal SFA, and the needle tip was advanced into the CFA stent and passed through the occluded lesion using a microcatheter and guide wire (GW). This allowed us to insert a guide catheter via the GW into the occluded lesion. No complications, such as bleeding, were observed after the procedure. When the CFA is occluded by a stent, an ascending approach through the proximal SFA is a viable treatment option. An occluded lesion due to a previously implanted stent makes approaching the common femoral artery difficult. Hence, alternative approaches are needed. In this regard, an approach via the proximal superficial femoral artery may prove useful. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. Coronary Intravascular Lithotripsy Effectiveness and Safety in a Real-World Cohort.
- Author
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Oliveira, Catarina, Vilela, Marta, Nobre Menezes, Miguel, Silva Marques, João, Jorge, Cláudia Moreira, Rodrigues, Tiago, Almeida Duarte, José, Marques da Costa, José, Carrilho Ferreira, Pedro, Francisco, Ana Rita, Cardoso, Pedro Pinto, and Pinto, Fausto J.
- Subjects
- *
DRUG-eluting stents , *INTRAVASCULAR ultrasonography , *CORONARY artery calcification , *PERCUTANEOUS coronary intervention , *LITHOTRIPSY , *ACUTE coronary syndrome , *MYOCARDIAL infarction - Abstract
Background: Coronary artery calcification is a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Intravascular lithotripsy (IVL) is a promising tool for the treatment of calcified lesions. The aim of this study was to assess the effectiveness and safety of IVL. Methods: A single-center observational study of PCI procedure, with assessment of the outcomes of patients undergoing PCI using IVL, was performed. Angiographic procedural success was used as the primary effectiveness endpoint. The primary safety endpoint was defined as a composite of cardiac death, myocardial infarction and target vessel revascularization within 30 days. Results: A total of 111 patients were included. Indications for PCI spanned the spectrum of chronic (53.2%) and acute coronary syndromes (43%). Lesion preparation before IVL was performed with non-compliant (42%), cutting or OPN (14.4%) balloons and with atherectomy techniques in 11% of procedures. Intravascular imaging was used in 21.6% of procedures. The primary effectiveness endpoint was achieved in 100% and the primary safety endpoint in 3.6% of procedures. Peri-procedural complications were minimal and successfully resolved. Conclusions: IVL was an effective and safe technique for the treatment of calcified coronary lesions. These findings contribute to the growing body of evidence supporting the use of IVL in the management of these challenging scenarios. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
11. Copenhagen Mesenteric Stent Study - A Randomized Trial of Stent Versus Covered Stent Treatment for Chronic Mesenteric Ischemia (COMESS)
- Author
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University of Copenhagen and Timothy Resch, Professor of Vascular Surgery
- Published
- 2023
12. Exercise Training in Coronary Artery Disease Patients After Stenting
- Published
- 2023
13. Effect of Exercise Training in Coronary Artery Disease Patients After Stenting
- Published
- 2023
14. PERFIL EPIDEMIOLÓGICO DOS PACIENTES SUBMETIDOS À ANGIOPLASTIA POR TROMBOSE/REESTENOSE DE STENT EM PACIENTES DA HEMODINÂMICA EM UM HOSPITAL DE GRANDE PORTE DO NORTE DO PARANÁ.
- Author
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RODRIGUES NOGUEIRA, DANIELA, GONCHOREK DE PAULA, LUANA FRANCISCA, PERUGINI STADTLOBER, CAMILA, SCHELL DE MORAES, ALBERTO CÉSAR, FREDERICO KOCH, ROBERTO, and DOS SANTOS REBELATO, ADÉLIA MARIA
- Abstract
Introduction: Acute Myocardial Infarction (AMI) is one of the main causes of hospitalizations, and consequently, of death in the modern world. Type 4 is the AMI related to stent thrombosis/restenosis in patients who have previously undergone to a endovascular treatment with stent implantation to restore coronary blood flow. Objectives: Investigate and collect data on the epidemiological and clinical profile, risk factors and use of patients' medications and the incidence of stent restenosis/thrombosis, type of stent used (pharmacological or not) and affected arteries in those treated at the Hemodynamics of a large hospital in the North of Paraná. Methodology: Quantitative, retrospective, descriptive, integrative and observational research, through analysis of the medical records of patients undergoing coronary angioplasty due to stent thrombosis/restenosis, in the period from July to December 2022.Result: A rate of 4.1% was found of CTA procedures performed in the service due to stent thrombosis/restenosis, 93.75% over 51 years old, 75% male, 81% with drug-eluting stent, with 93.75% of patients with at least 3 risk factors; 87.5% being hypertensive, followed by 62.5% smokers, 56.5% dyslipidemia, 50% diabetic and 25% sedentary; 62.5% admitted with unstable angina, 37.5% requiring ICU admission, and 12.5% deaths. Argument: as the data collected, there was agreement between the study and those found in the scientific literature, where: the prevalence of restenosis is higher than stent thrombosis, that SAH was the main risk factor in both groups and gender, a strong relationship between risk factor and restenosis and suspected strong association between poor medication adherence and event. Conclusion: This study, carried out by collecting data through analysis of medical records, showed agreement with data from the scientific literature found. With limitations to the study, such as the retrospective analysis that did not allow evaluating conditions other than those provided in the medical records. It is suggested that strategies be developed through continued work, with the possibility of collecting other pertinent data such as medication adherence and other risk factors involved, to reduce events, with an impact not only on mortality but also on the quality of life of these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
15. The Value of IVL Compared To OPN Non-Compliant Balloons for Treatment of RefractorY Coronary Lesions (VICTORY) Trial (VICTORY)
- Author
-
Matthias Bossard, Co-Principal Investigator
- Published
- 2023
16. Coronary Intravascular Lithotripsy Effectiveness and Safety in a Real-World Cohort
- Author
-
Catarina Oliveira, Marta Vilela, Miguel Nobre Menezes, João Silva Marques, Cláudia Moreira Jorge, Tiago Rodrigues, José Almeida Duarte, José Marques da Costa, Pedro Carrilho Ferreira, Ana Rita Francisco, Pedro Pinto Cardoso, and Fausto J. Pinto
- Subjects
calcified coronary artery disease ,intravascular coronary lithotripsy ,left main artery disease ,stent restenosis ,Medicine - Abstract
Background: Coronary artery calcification is a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Intravascular lithotripsy (IVL) is a promising tool for the treatment of calcified lesions. The aim of this study was to assess the effectiveness and safety of IVL. Methods: A single-center observational study of PCI procedure, with assessment of the outcomes of patients undergoing PCI using IVL, was performed. Angiographic procedural success was used as the primary effectiveness endpoint. The primary safety endpoint was defined as a composite of cardiac death, myocardial infarction and target vessel revascularization within 30 days. Results: A total of 111 patients were included. Indications for PCI spanned the spectrum of chronic (53.2%) and acute coronary syndromes (43%). Lesion preparation before IVL was performed with non-compliant (42%), cutting or OPN (14.4%) balloons and with atherectomy techniques in 11% of procedures. Intravascular imaging was used in 21.6% of procedures. The primary effectiveness endpoint was achieved in 100% and the primary safety endpoint in 3.6% of procedures. Peri-procedural complications were minimal and successfully resolved. Conclusions: IVL was an effective and safe technique for the treatment of calcified coronary lesions. These findings contribute to the growing body of evidence supporting the use of IVL in the management of these challenging scenarios.
- Published
- 2024
- Full Text
- View/download PDF
17. Ultrathin DES in Complex PCI Scenarios: the ULTRA a Multicenter Study (ULTRA)
- Author
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Fabrizio D'Ascenzo, Clinical Professor
- Published
- 2022
18. Is There an Advantage of Ultrathin-Strut Drug-Eluting Stents over Second- and Third-Generation Drug-Eluting Stents?
- Author
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Gherasie, Flavius-Alexandru, Valentin, Chioncel, and Busnatu, Stefan-Sebastian
- Subjects
- *
PRASUGREL , *SURGICAL stents , *ST elevation myocardial infarction , *PERCUTANEOUS coronary intervention , *DRUG coatings , *DELAYED hypersensitivity , *KOUNIS syndrome - Abstract
In patients undergoing percutaneous coronary intervention, the second-generation drug-eluting stents (DES) are considered the gold standard of care for revascularization. By reducing neointimal hyperplasia, drug-eluting coronary stents decrease the need for repeat revascularizations compared with conventional coronary stents without an antiproliferative drug coating. It is important to note that early-generation DESs were associated with an increased risk of very late stent thrombosis, most likely due to delayed endothelialization or a delayed hypersensitivity reaction to the polymer. Studies have shown a lower risk of very late stent thrombosis with developing second-generation DESs with biocompatible and biodegradable polymers or without polymers altogether. In addition, research has indicated that thinner struts are associated with a reduced risk of intrastent restenosis and angiographic and clinical results. A DES with ultrathin struts (strut thickness of 70 µm) is more flexible, facilitates better tracking, and is more crossable than a conventional second-generation DES. The question is whether ultrathin eluting drug stents suit all kinds of lesions. Several authors have reported that improved coverage with less thrombus protrusion reduced the risk of distal embolization in patients with ST-elevation myocardial infarction (STEMI). Others have described that an ultrathin stent might recoil due to low radial strength. This could lead to residual stenosis and repeated revascularization of the artery. In CTO patients, the ultrathin stent failed to prove non-inferiority regarding in-segment late lumen loss and showed statistically higher rates of restenosis. Ultrathin-strut DESs with biodegradable polymers have limitations when treating calcified (or ostial) lesions and CTOs. However, they also possess certain advantages regarding deliverability (tight stenosis, tortuous lesions, high angulation, etc.), ease of use in bifurcation lesions, better endothelialization and vascular healing, and reducing stent thrombosis risk. In light of this, ultrathin-strut stents present a promising alternative to existing DESs of the second and third generation. The aims of the study are to compare ultrathin eluting stents with second- and third-generation conventional stents regarding procedural performance and outcomes based on different lesion types and specific populations. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
19. Management of In-stent Restenosis.
- Author
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Chhabra, Shibba and Majella, J. Cecily Mary
- Subjects
PERCUTANEOUS coronary intervention ,SURGICAL stents ,HYPERPLASIA ,CORONARY restenosis ,CORONARY angiography ,TREATMENT effectiveness ,OPTICAL coherence tomography ,RADIOISOTOPE brachytherapy ,LITHOTRIPSY - Abstract
Despite recent improvements in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) -- which accounts for 5-10% of all PCI procedures in contemporary clinical practice remains a substantial problem and the most frequent reason for stent failure. While the absolute number of ISR-PCI operations performed in contemporary practice has increased as a result of rising procedural volume and complexity, the relative rate of ISR has decreased with newer-generation drug eluting stents (DESs) in comparison to the bare metal stent (BMS) period. While BMS ISR is usually early and characterized by neointimal hyperplasia, DES ISR tends to be late with neoatherosclerosis as a characteristic feature. According to recent research, drug-coated balloons or DESs are the most effective therapy options for the majority of ISR cases. Future ISR interventional paradigms may be influenced by intravascular imaging (IVI) ISR tissue patterns. IVI can provide useful information to guide treatment options in ISR-PCI. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. A Unique Challenge in Management in the Emergency Department and Cardiac Cathlab: Case Review of Two Subjects with Kounis Syndrome Complicated with ST Elevation Myocardial Infarction and Ventricular Tachycardia, Following Exposure to Cutaneous or Intravenous Allergens
- Author
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P. M. Athauda Arachchi, N. Yahampath, and S. Rajapakse
- Subjects
kounis syndrome ,anaphylaxis ,stemi ,ventricular tachycardia ,acute coronary plaque rupture ,primary pci ,drug eluting stents ,bare metal stents ,stent thrombosis ,stent restenosis ,Medicine - Abstract
Acute coronary syndromes, such as coronary spasm or acute myocardial infarction, have been reported following allergic reactions. These are known to affect patients of any age, and can have a variety of clinical manifestations, and are collectively referred to as Kounis syndrome [1]. We report 2 cases of acute myocardial infarction complicated by severe cardiac dysrhythmia, following an acute allergic reaction to cutaneous or intravenous allergens. To our knowledge, this is the first instance of a skin contact with caterpillar has been documented to provoke Kounis syndrome complicated by an acute STEMI with polymorphic VT. Management of such patients could be hazardous, particularly in emergency units and cardiac catheter labs, when decisions on drugs and urgent revascularization need to be made on a background of inflammation induced by severe allergic reactions. In theory, bare metal stents (when appropriate), Polymer free, Bio-absorbable scaffolds or rapid healing Drug Eluting Stents offer a better safety profile in emergency PCI, but according to our knowledge, duration of antiplatelet drugs and relative safety of various types of stents with variable drug and polymer combinations have not been formally evaluated in this condition in randomised control trials. The risk of early and late stent thrombosis and restenosis with chronic inflammation may be difficult to predict in the long term, without follow up data from trials. Such trials are very difficult to set up given the low volumes and emergency nature of events, hence review of clinical case series like ours will be invaluable to gain more insight into rapid decision making required in this interesting clinical syndrome. Reassuringly, both our patients who had emergency PCI with either Biolimus, Everolimus eluting or bare metal stents respectively in the acute setting, have not experienced repeat hospitalizations for ACS, arrhythmia or a repeat revascularization procedure at 7 and 5year follow-ups respectively.
- Published
- 2022
- Full Text
- View/download PDF
21. Integrated Distance Management Strategy for Patients With Cardiovascular Diseases in the Context of COVID-19 (eCardioCovid19)
- Author
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Medical Sciences Academy - Romania, Victor Babes Clinical Hospital of Infectious Diseases - Bucharest, and Professor Adrian Covic, Professor, Vice-rector
- Published
- 2020
22. Self-expanding Nitinol Stents of High vs. Low Chronic Outward Force in De-novo Femoropopliteal Occlusive Arterial Lesions (BIOFLEX-COF)
- Author
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Alexander Wressnegger, Dr.med.univ.
- Published
- 2020
23. Restenosis after Coronary Stent Implantation: Cellular Mechanisms and Potential of Endothelial Progenitor Cells (A Short Guide for the Interventional Cardiologist).
- Author
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Gori, Tommaso
- Subjects
- *
PROGENITOR cells , *CORONARY restenosis , *SURGICAL stents , *CARDIOLOGISTS , *MEDICAL personnel , *ENDOTHELIAL cells - Abstract
Coronary stents are among the most common therapies worldwide. Despite significant improvements in the biocompatibility of these devices throughout the last decades, they are prone, in as many as 10–20% of cases, to short- or long-term failure. In-stent restenosis is a multifactorial process with a complex and incompletely understood pathophysiology in which inflammatory reactions are of central importance. This review provides a short overview for the clinician on the cellular types responsible for restenosis with a focus on the role of endothelial progenitor cells. The mechanisms of restenosis are described, along with the cell-based attempts made to prevent it. While the focus of this review is principally clinical, experimental evidence provides some insight into the potential implications for prevention and therapy of coronary stent restenosis. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
24. Post-PCI OCT Findings and the Clinical Significance
- Author
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Yonetsu, Taishi and Jang, Ik-Kyung, editor
- Published
- 2020
- Full Text
- View/download PDF
25. A systematic review of DVT and stent restenosis after stent implantation for iliac vein compression syndrome
- Author
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Hongyu Wang, Anqiang Sun, Yuan Li, Yifeng Xi, Yubo Fan, Xiaoyan Deng, and Zengsheng Chen
- Subjects
Iliac vein compression syndrome ,Iliac vein stent ,Stent treatment ,Hemodynamic ,Deep venous thrombosis ,Stent restenosis ,Medical technology ,R855-855.5 - Abstract
Iliac vein compression syndrome (IVCS) is a common venous disease caused by joint compression of the right common iliac artery and the lumbosacral vertebrae. The compression of iliac vein not only causes venous hypertension in the lower extremities, but also induces venous valve dysfunction and superficial varicose veins in lower extremities. Moreover, the compression of iliac vein is an important potential factor for iliofemoral vein thrombosis. Currently, open surgery and stent implantation are the main treatment for IVCS. Due to the advantages of minimally invasive and postoperative patency, stent implantation for IVCS has gradually become the standard treatment. However, when the stent is implanted into the iliac vein to treat IVCS, the complications, such as restenosis, deep vein thrombosis (DVT) appear, which affect the patency of stent and hamper the patient recovery. Up to now, the mechanism how the stent implantation induces the restenosis and DVT is still unclear. In this review, we summarized the clinical symptoms, treatment methods of IVCS and the complications after stent implantation, and analyzed the mechanism of stent restenosis and DVT, and finally discuss the iliac vein stent design specifically for treating IVCS.
- Published
- 2022
- Full Text
- View/download PDF
26. Microarray meta-analysis reveals IL6 and p38β/MAPK11 as potential targets of hsa-miR-124 in endothelial progenitor cells: Implications for stent re-endothelization in diabetic patients
- Author
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Alberto Arencibia and Luis A. Salazar
- Subjects
circulating progenitor endothelial cells ,stent restenosis ,diabetes ,microarray meta-analysis ,micro-RNA ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Circulating endothelial progenitor cells (EPCs) play an important role in the repair processes of damaged vessels, favoring re-endothelization of stented vessels to minimize restenosis. EPCs number and function is diminished in patients with type 2 diabetes, a known risk factor for restenosis. Considering the impact of EPCs in vascular injury repair, we conducted a meta-analysis of microarray to assess the transcriptomic profile and determine target genes during the differentiation process of EPCs into mature ECs. Five microarray datasets, including 13 EPC and 12 EC samples were analyzed, using the online tool ExpressAnalyst. Differentially expressed genes (DEGs) analysis was done by Limma method, with an | log2FC| > 1 and FDR < 0.05. Combined p-value by Fisher exact method was computed for the intersection of datasets. There were 3,267 DEGs, 1,539 up-regulated and 1,728 down-regulated in EPCs, with 407 common DEGs in at least four datasets. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed enrichment for terms related to “AGE-RAGE signaling pathway in diabetic complications.” Intersection of common DEGs, KEGG pathways genes and genes in protein-protein interaction network (PPI) identified four key genes, two up-regulated (IL1B and STAT5A) and two down-regulated (IL6 and MAPK11). MicroRNA enrichment analysis of common DEGs depicted five hub microRNA targeting 175 DEGs, including STAT5A, IL6 and MAPK11, with hsa-miR-124 as common regulator. This group of genes and microRNAs could serve as biomarkers of EPCs differentiation during coronary stenting as well as potential therapeutic targets to improve stent re-endothelization, especially in diabetic patients.
- Published
- 2022
- Full Text
- View/download PDF
27. Is There an Advantage of Ultrathin-Strut Drug-Eluting Stents over Second- and Third-Generation Drug-Eluting Stents?
- Author
-
Flavius-Alexandru Gherasie, Chioncel Valentin, and Stefan-Sebastian Busnatu
- Subjects
eluting drug stents ,ultrathin-strut eluting stents ,stent thrombosis ,stent restenosis ,calcified coronary lesions ,neointimal hyperplasia ,Medicine - Abstract
In patients undergoing percutaneous coronary intervention, the second-generation drug-eluting stents (DES) are considered the gold standard of care for revascularization. By reducing neointimal hyperplasia, drug-eluting coronary stents decrease the need for repeat revascularizations compared with conventional coronary stents without an antiproliferative drug coating. It is important to note that early-generation DESs were associated with an increased risk of very late stent thrombosis, most likely due to delayed endothelialization or a delayed hypersensitivity reaction to the polymer. Studies have shown a lower risk of very late stent thrombosis with developing second-generation DESs with biocompatible and biodegradable polymers or without polymers altogether. In addition, research has indicated that thinner struts are associated with a reduced risk of intrastent restenosis and angiographic and clinical results. A DES with ultrathin struts (strut thickness of 70 µm) is more flexible, facilitates better tracking, and is more crossable than a conventional second-generation DES. The question is whether ultrathin eluting drug stents suit all kinds of lesions. Several authors have reported that improved coverage with less thrombus protrusion reduced the risk of distal embolization in patients with ST-elevation myocardial infarction (STEMI). Others have described that an ultrathin stent might recoil due to low radial strength. This could lead to residual stenosis and repeated revascularization of the artery. In CTO patients, the ultrathin stent failed to prove non-inferiority regarding in-segment late lumen loss and showed statistically higher rates of restenosis. Ultrathin-strut DESs with biodegradable polymers have limitations when treating calcified (or ostial) lesions and CTOs. However, they also possess certain advantages regarding deliverability (tight stenosis, tortuous lesions, high angulation, etc.), ease of use in bifurcation lesions, better endothelialization and vascular healing, and reducing stent thrombosis risk. In light of this, ultrathin-strut stents present a promising alternative to existing DESs of the second and third generation. The aims of the study are to compare ultrathin eluting stents with second- and third-generation conventional stents regarding procedural performance and outcomes based on different lesion types and specific populations.
- Published
- 2023
- Full Text
- View/download PDF
28. Clinical implications of the invagination of an interwoven nitinol stent: a single-center retrospective analysis.
- Author
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Kojima, Shunsuke, Nakama, Tatsuya, Muraishi, Makio, Azumi, Yuta, Obunai, Kotaro, and Watanabe, Hiroshi
- Abstract
Stent invagination (SIV) sometimes occurs during interwoven nitinol stent (IWS) placement due to its complex deployment system. It may cause stent malapposition and reduce the minimum stent area. However, the clinical implications of SIV remain unclear. This retrospective single-center study sought to assess the clinical implications of IWS invagination in the femoropopliteal lesions in patients with peripheral arterial diseases. Thirty-two consecutive patients (23 men, mean age of 74 years, 34 limbs) with symptomatic femoropopliteal lesions who had received IWS implantation from January to July 2019 were enrolled. The study was approved by the ethics committee of our institution. The 12-month primary patency rate after the initial IWS placement was evaluated as the primary outcome, which was compared between lesions with SIV (SIV cohort) and without SIV (non-SIV cohort). All IWSs were deployed successfully, but nine cases (26.4%) of SIV occurred during placement. The mean lesion length was 22.3 cm, and critical limb threatening ischemia was observed in 40.6% of the limbs. The overall 12-month primary patency rate was 78.2%. The non-SIV cohort (25 cases) showed a significantly higher primary patency rate than the SIV cohort (9 cases, 91.7% vs. 41.7%, P = 0.0149). IWS implantation showed acceptable durability in Japanese patients in a real-world setting, however, SIV during IWS placement possibly led to a lower 12-month primary patency rate. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
29. veRy Thin Stents for Patients With Left mAIn or bifurcatioN in Real Life: the RAIN a Multicenter Study (RAIN)
- Author
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University Hospital, Zürich and Fabrizio D'Ascenzo, Principal Investigator
- Published
- 2018
30. Matrix Metalloproteinases Expression in the Neointimal Hyperplasia Induced by Drug Eluting Stent (DES) Implantation
- Author
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Tae Soo Kang, Associate Professor
- Published
- 2017
31. Pathogenetic mechanism of stented coronary arteries restenosis and the role of vasculoendothelial growth factor A
- Author
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M.P. Kopytsya, I.M. Kutya, and I.R. Vyshnevska
- Subjects
vascular endothelial growth factor-a ,stent restenosis ,polymorphism of the vegf-a gene ,acute myocardial infarction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The contemporary issue of in-stent restenosis is reviewed in the article. The widespread use of interventional technologies for the treatment of acute and chronic forms of ischemic heart disease led to the appearance of the problem of coronary artery restenosis at the implantation site. The problem was apparently solved through introduction of drug-eluting stents instead of bare-metal stents. However, these stents also led to restenosis, but in more remote period. The issue of the contemporary cardiology is how to avoid this complication. Risk stratification of restenosis development in various groups of patients is a main task today, as the treatment of this condition is not simple. The article analyzes data of the studies conducted up to date. It studies the pathogenetic mechanisms that would develop restenosis of the previously stented coronary arteries (in various stents) and factors contributing to the formation of restenosis. The results of the studies show that vasculoendothelial growth factor-A (VEFR-A) plays a role in the development of restenosis and might predict the formation of this complication. The review addresses the issues of different genotypes of VEFR-A, which may predispose to the formation of stent restenosis.
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- 2019
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32. The Effect of Vitamin D Deficiency on the Risk and Time of Stent Restenosis After Percutaneous Coronary Angioplasty: Case-Control Study.
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ERDEM YAMAN, Aysun and CEYLAN, Ufuk Sadık
- Subjects
- *
VITAMIN D deficiency , *TRANSLUMINAL angioplasty , *VITAMIN D , *ANGIOPLASTY , *CORONARY restenosis - Abstract
Objective: Many studies have emphasized the role of inflammation in the development of stent restenosis after percutaneous transluminal coronary angioplasty (PTCA). Vitamin D plays an important role in the modulation of the inflammatory system. Recent studies suggest that vitamin D deficiency is associated with an increased risk of cardiovascular disease. The aim of this study was to investigate the association between vitamin D levels and the development of stent restenosis and the time course of stent restenosis after PTCA. Material and Methods: Fifty-eight patients (Group 1) were consecutively selected among patients admitted to Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital with angina pectoris who developed stent restenosis following PTCA. The control group patients (Group 2) had no stent restenosis following PTCA. Results: The 25(OH) D values were lower in patients with stent restenosis. The difference was significant (11.2 ng/mL vs. 13.8 ng/mL, p=0.02). The risk of restenosis increased 3.4 times when vitamin D level was below 11.3 ng/mL (area under the curve=0.651, 95% confidence interval 0.529-0.773, p=0.02). Also, as time elapsed after PTCA, there was a statistically insignificant weak negative correlation between vitamin D and risk and the time course of stent restenosis (r=-0.181, p=0.219). Conclusion: These findings indicate that lower serum vitamin D levels increase the risk of stent restenosis following coronary interventions. Vitamin D may be a marker for predicting stent restenosis. The already increased risk of restenosis may augment over time as patients' vitamin D levels remain low. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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- View/download PDF
33. Additional ablation effect of low‐speed rotational atherectomy following high‐speed rotational atherectomy on early calcified in‐stent restenosis: A case report.
- Author
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Hamana, Tomoyo, Yamamoto, Hiroyuki, Sawada, Takahiro, Kawai, Hiroya, and Takaya, Tomofumi
- Subjects
- *
PERCUTANEOUS coronary intervention , *ATHERECTOMY - Abstract
Optical frequency domain imaging‐guided additional low‐speed rotational atherectomy following sufficient high‐speed rotational atherectomy for early calcified in‐stent restenosis might be a safe and useful option for achieving additional large lumen gains and stent expansion. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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- View/download PDF
34. Additional ablation effect of low‐speed rotational atherectomy following high‐speed rotational atherectomy on early calcified in‐stent restenosis: A case report
- Author
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Tomoyo Hamana, Hiroyuki Yamamoto, Takahiro Sawada, Hiroya Kawai, and Tomofumi Takaya
- Subjects
drug‐eluting stent ,percutaneous coronary intervention ,rotational atherectomy ,stent restenosis ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Optical frequency domain imaging‐guided additional low‐speed rotational atherectomy following sufficient high‐speed rotational atherectomy for early calcified in‐stent restenosis might be a safe and useful option for achieving additional large lumen gains and stent expansion.
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- 2021
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35. Periodontitis Is Associated With Risk of Conventional Stent Restenosis: Pilot Case-Control Study
- Author
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Raphael Osugue, Nidia C. Castro dos Santos, Cassia F. Araujo, Flavio X. de Almeida, Magda Feres, and Mauro P. Santamaria
- Subjects
atherosclerosis ,cardiovascular disease ,stent restenosis ,periodontitis ,inflammation ,Dentistry ,RK1-715 - Abstract
Objectives: Percutaneous coronary angioplasty with stent implantation has been established as the main form of treatment of atherosclerosis. However, 16 to 44% of patients may evolve with stent restenosis. Periodontitis is an inflammatory condition associated with bacterial infection, that may lead to periodontal tissue destruction and tooth loss. This study aimed to evaluate the association between stent restenosis and periodontitis.Materials and Methods: Coronary angiography exams presenting stent imaging with and without restenosis were analyzed. Patients meeting the inclusion and exclusion criteria were selected and allocated in 2 groups: case (restenosis) and control (without restenosis). We evaluated if systemic and periodontal variables were predictors of restenosis (primary outcome) using a multivariable stepwise logistic regression. Additionally, we compared clinical and periodontal conditions between the control and case groups (secondary outcomes) using Chi-square test and ANOVA test.Results: Data from 49 patients (case n = 15; control n = 34) were analyzed. The results showed that stages III and IV periodontitis and lack of physical activity were significant predictors of stent restenosis (OR 5.82 and 5.98, respectively). Comparisons regarding the diagnosis of periodontal conditions between control and case groups did not present significant differences in the incidence of periodontitis and alveolar bone loss.Conclusion: Stages III and IV periodontitis increased the incidence of stent restenosis. These findings suggest that advanced stages of periodontal disease might lead to the occurrence of negative outcomes after coronary angioplasty with stent placement.
- Published
- 2021
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36. Six-year outcomes of carotid artery stenting performed with multidisciplinary management in a single center.
- Author
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Köklü, Erkan, Arslan, Şakir, Gencer, Elif Sarıönder, Bayar, Nermin, Avcı, Rauf, and Özgünoğlu, Edip Can
- Subjects
- *
CAROTID artery , *MAGNETIC resonance imaging , *CAROTID endarterectomy ,CAROTID artery stenosis - Abstract
Objective: This study aimed to evaluate the first 30-day results of clinical, periprocedural asymptomatic cranial embolism, and long-term restenosis of the multidisciplinary conducted and evaluated carotid artery stenting (CAS) procedure in our patient group with real-life data. Methods: A total of 610 patients who were subjected to consecutive CAS procedures in our center between December 2010 and February 2019 were clinically and radiologically followed up for a mean duration of 6 years. Of the 610 patients, 274 (45%) were symptomatic for carotid artery stenosis, whereas 336 (55%) were identified as asymptomatic. As embolism protection methods, distal protection, proximal protection, and double (distal + proximal) protection was used in 52%, 43%, and 0.3% of patients, respectively. Results: The success rate of the CAS procedure was 96%. Procedure-related death was reported in 4 (0.6%) patients who successfully underwent the CAS procedure. Moreover, acute carotid artery stent thrombosis, hyperperfusion syndrome, periprocedural major stroke, and periprocedural minor stroke was observed in 4 (0.6%), 2 (0.3%), 2 (0.3%), and 12 (1.9%) patients, respectively. The total clinical complication rates during the first 30 periprocedural days were 1.6% (10 patients) and 3.1% (19 patients) in the asymptomatic and symptomatic groups, respectively. On cranial magnetic resonance imaging performed, asymptomatic ipsilateral cranial microembolism, asymptomatic contralateral cranial microembolism, and bilateral asymptomatic cranial microembolism was detected in 61 (11.6%), 20 (3.8%), 23 (4.4%) patients, respectively. Asymptomatic restenosis was observed in 24 (3.9%) patients. Conclusion: The CAS procedure is a reliable treatment option applicable with acceptable complication and success rates as outlined in the guidelines, when performed following a multidisciplinary evaluation, in the treatment of symptomatic and asymptomatic carotid artery stenosis, including high-risk patient groups. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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37. Restenosis after Coronary Stent Implantation: Cellular Mechanisms and Potential of Endothelial Progenitor Cells (A Short Guide for the Interventional Cardiologist)
- Author
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Tommaso Gori
- Subjects
coronary arteries ,inflammation ,stent ,stent thrombosis ,stent restenosis ,Cytology ,QH573-671 - Abstract
Coronary stents are among the most common therapies worldwide. Despite significant improvements in the biocompatibility of these devices throughout the last decades, they are prone, in as many as 10–20% of cases, to short- or long-term failure. In-stent restenosis is a multifactorial process with a complex and incompletely understood pathophysiology in which inflammatory reactions are of central importance. This review provides a short overview for the clinician on the cellular types responsible for restenosis with a focus on the role of endothelial progenitor cells. The mechanisms of restenosis are described, along with the cell-based attempts made to prevent it. While the focus of this review is principally clinical, experimental evidence provides some insight into the potential implications for prevention and therapy of coronary stent restenosis.
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- 2022
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38. Effect of Tongguan Capsules (通冠胶囊) on Restenosis after Coronary Stent Implantation: Study Protocol for A Randomized Controlled Trial.
- Author
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Zhou, Yuan-shen, Mao, Shuai, Guo, Li-heng, Gao, Xiong-yi, Zou, Xu, and Zhang, Min-zhou
- Subjects
CORONARY restenosis prevention ,ANGINA pectoris ,ANTICOAGULANTS ,PHARMACEUTICAL encapsulation ,HERBAL medicine ,CHINESE medicine ,MYOCARDIAL infarction ,STATISTICAL sampling ,SURGICAL stents ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,PLATELET aggregation inhibitors ,PERCUTANEOUS coronary intervention ,DRUG administration ,DRUG dosage ,THERAPEUTICS - Abstract
Background: Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (通冠胶囊), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate. Objective: This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation. Methods: Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months. Conclusion: This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407) [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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39. Association of monocyte to high-density lipoprotein ratio with bare-metal stent restenosis in STEMI patients treated with primary PCI.
- Author
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Avci, Ilhan Ilker, Sahin, Irfan, Gungor, Baris, Karatas, Mehmet Baran, Ozcan, Kazim Serhan, Canga, Yigit, Keskin, Muhammet, Hayiroglu, Mert Ilker, Karadeniz, Fatma Ozpamuk, and Sungur, Aylin
- Subjects
MONOCYTES ,LIPOPROTEINS ,PERCUTANEOUS coronary intervention ,ANGIOGRAPHY ,CORONARY restenosis - Abstract
OBJECTIVE: Monocyte to high-density lipoprotein ratio (MHR) has recently been postulated as a novel parameter related to adverse cardiovascular outcomes. In this study, we aimed to investigate the correlation of MHR with stent restenosis (SR) rates after the primary percutaneous coronary intervention (PCI) and bare-metal stent (BMS) implantation. METHODS: In this study, patients who had undergone primary PCI for STEMI and had a control angiogram during follow-up were retrospectively recruited. Patients were categorized according to admission MHR tertiles, clinical and angiographic data were compared. In addition, predictors of SR were evaluated with logistic regression analysis. RESULTS: A total number of 448 patients (240 patients with SR and 208 patients without SR) were included in this study. Patients were categorized into three groups according to tertiles of admission MHR. During a follow-up period of median 12 months, the rate of SR was significantly higher in patients with higher MHR levels (45% in tertile 1, 54% in tertile 2 and 62% in tertile 3, p<0.01). In multivariate Cox regression analysis, male gender, stent length, admission NLR levels and MHR levels (HR 1.03, 95% CI 1.02-1.06, p<0.01) remained as the independent predictors of SR in the study population. CONCLUSION: Gender, stent length, higher MHR and NLR levels are correlated to SR after primary PCI. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
40. Intravascular Molecular Imaging of Proteolytic Activity
- Author
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Osborn, Eric A., Jaffer, Farouc A., and Aikawa, Elena, editor
- Published
- 2015
- Full Text
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41. Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
- Author
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Katharina Schochlow, Melissa Weissner, Florian Blachutzik, Niklas F. Boeder, Monique Tröbs, Liv Lorenz, Jouke Dijkstra, Thomas Münzel, Stephan Achenbach, Holger Nef, and Tommaso Gori
- Subjects
coronary stent ,bioresorbable scaffold ,optical coherence tomography ,stent thrombosis ,stent restenosis ,Medicine - Abstract
Introduction. The frequency, characteristics and clinical implications of Strut fractures (SFs) remain incompletely understood. Methods and results. A total of 185 (160 patients) newer-generation drug-eluting stents (DES) were imaged. SFs were found in 21 DES (11.4%) and were classified in four patterns: one single stacked strut (41%); two or more stacked struts (23%); deformation without gap (27%); transection (9%). In multivariable analysis, calcific and bifurcation lesions were associated with SF in DES (OR: 3.5 [1.1–11] and 4.0 [2.2–7.2], p < 0.05). Device eccentricity and asymmetry as well as optical coherence tomography (OCT) features of impaired strut healing were also associated with SF. The prevalence of fractures was similar in a set of 289 bioresorbable scaffolds (BRS). In a separate series of 20 device thromboses and 36 device restenoses, the prevalence of SF was higher (61.2% of DES and 66.7% of BRS, p < 0.001 for both), with a higher frequency of complex SF patterns (p < 0.0001). In logistic regression analysis, fractures were a correlate of device complications (p < 0.0001, OR = 24.9 [5.6–111] for DES and OR = 6.0 [1.8–20] for BRS). Discussion. The prevalence of OCT-diagnosed SF was unexpectedly high in the setting of elective controls and it increased by about three-fold in the setting of device failure. Fractures were associated with increased lesion complexity and device asymmetry/eccentricity and were more frequent in the setting of device failure such as restenosis and thrombosis.
- Published
- 2021
- Full Text
- View/download PDF
42. Clinical and Laboratory Predictors of Major Adverse Cardiac Events in Patients with Ischemic Heart Disease Following Elective Percutaneous Coronary Intervention
- Author
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E. Z. Golukhova, M. V. Grigoryan, M. N. Ryabinina, and N. I. Bulaeva
- Subjects
dual antiplatelet therapy ,platelet aggregation ,coronary artery stenting ,stent thrombosis ,stent restenosis ,plasminogen activator inhibitor -1 ,von willebrand factor ,Therapeutics. Pharmacology ,RM1-950 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background. Despite recent advances in stent design and constantly improving protective pharmacological strategies, complications and adverse events following percutaneous coronary interventions (PCI) are still major factors influencing morbidity and mortality. Therefore, predicting secondary vascular occlusions represents an unmet medical need.Aim. To triage clinical and laboratory predictors of major adverse clinical events (MACE) following coronary stenting.Material and methods. This was a prospective, case-controlled, single-center study, which included 94 consecutive patients with documented ischemic heart disease (IHD) who underwent PCI with drug-eluting stent implantation. All patients received dual antiplatelet therapy with acetyl salicylic acid and clopidogrel. Numerous clinical characteristics and laboratory biomarkers were assessed before stenting, as well as CYP2C19 genotyping after patient’s discharge and were correlated with poststenting MACE over the mean follow-up of 28 months. MACE included death, nonfatal myocardial infarction, target vessel revascularisation, stroke, stent thrombosis, angina recurrence and in-stent restenosis.Results. Twenty-three patients experienced MACE. According to univariate regression analysis we found following MACE predictors after PCI: diabetes mellitus (p=0.049), P2Y12 Reaction Units (PRU) according to VerifyNow® (p=0.01), number of stented arteries more than 2 (p=0.01), number of implanted stents more than 2 (p=0.01), baseline levels of plasminogen activator inhibitor-1 (PAI-1) (p=0.03) and von Willebrand activity (vWF) (p=0.01). Using multivariate analysis we demonstrated that concomitant diabetes mellitus, PRU ≥202, PAI-1 level ≥75.95 ng/ml, von Willebrand factor activity ≥155.15% are independent predictors of adverse cardiac events after PCI in stable IHD patients. Other clinical characteristics and laboratory indices, including CYP2C19*2 carriage, showed no significant impact on outcomes after elective PCI. Conclusions. Background diabetes mellitus, high on-treatment platelet reactivity (according to VerifyNow®), PAI-1 and vWF presenting activity may be useful for MACE prediction over 28 months of follow-up after PCI with drug-eluting stent implantation.
- Published
- 2016
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43. Vascular Wall Reactions to Coronary Stents—Clinical Implications for Stent Failure
- Author
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Tommaso Gori
- Subjects
coronary arteries ,inflammation ,stent ,stent thrombosis ,stent restenosis ,Science - Abstract
Coronary stents belong to the most commonly implanted devices worldwide. A number of different types of stent exist, with very different mechanical and biochemical characteristics that influence their interactions with vascular tissues. Inappropriate inflammatory reactions are the major cause of the two major complications that follow implantation of stents in a percentage as high as 5–20%. It is therefore important to understand these reactions and how different they are among different generations of stents.
- Published
- 2021
- Full Text
- View/download PDF
44. Incidence of major adverse cardiac events in men wishing to continue competitive sport following percutaneous coronary intervention.
- Author
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Guy, Jean-Michel, Wilson, Mathew, Schnell, Frédéric, Chevalier, Laurent, Verdier, Jean-Claude, Corone, Sonia, Doutreleau, Stéphane, Kervio, Gaelle, and Carré, François
- Abstract
Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
- Full Text
- View/download PDF
45. Impact of advanced glycation end products (AGEs) signaling in coronary artery disease.
- Author
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Kosmopoulos, Marinos, Drekolias, Dimitrios, Zavras, Phaedon D., Piperi, Christina, and Papavassiliou, Athanasios G.
- Subjects
- *
ADVANCED glycation end-products , *CORONARY disease , *CELLULAR signal transduction , *MORTALITY , *PEOPLE with diabetes - Abstract
Abstract Coronary artery disease remains the leading cause of mortality in adult diabetic population with however, a high predominance also in non-diabetic subjects. In search of common molecular mechanisms and metabolic by-products with potential pathogenic role, increased advanced glycation end products (AGEs) present a critical biomarker for CAD development in both cases. Interaction of AGEs with their transmembrane cell receptor, RAGE in endothelial and smooth muscle cells as well as in platelets, activates intracellular signaling that leads to endothelial injury, modulation of vascular smooth muscle cell function and altered platelet activity. Furthermore, tissue accumulation of AGEs affects current treatment approaches being involved in stent restenosis. The present review provides an update of AGE-induced molecular mechanisms involved in CAD pathophysiology while it discusses emerging therapeutic interventions targeting AGE reduction and AGE-RAGE signaling with beneficial clinical outcome. Graphical abstract Unlabelled Image Highlights • Advanced glycation end products (AGEs) are involved in CAD pathogenesis. • AGEs crosslink extracellular matrix proteins and increase vascular stiffness. • AGEs-Receptor for AGEs (RAGE) signaling disrupts endothelial homeostasis. • AGEs modulate vascular smooth muscle cells functions and platelet activity. • AGE-RAGE signaling axis is involved in stent restenosis. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
46. Recanalization of Totally Occluded Stent of Superficial Femoral Artery with Multiple Direct Stent Puncture.
- Author
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Bildirici, Ibrahim Halil Ulas, Acar, Burak, Karauzum, Kurtulus, and Torun, Akın
- Subjects
- *
FEMORAL artery , *DRUG-eluting stents - Abstract
In-stent restenosis (ISR) is a frequent complication of endovascular stents implantation, especially in the superficial femoral artery (SFA). Beyond the standard interventions, direct stent puncture (DSP) to the totally occluded SFA increases the success rate of the endovascular procedures. Multiple attempts are required to treat total occlusions most of time. DSP useful and safe technique and provide good angiographic results. Beside the classical DSP, in this case we discussed recanalization of totally occluded stent of superficial femoral artery with bidirectional stent puncture. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
47. CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
- Author
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B. L. Mironkov, V. V. Chestukhin, I. Yu. Tyunyaeva, I. G. Ryadovoy, E. N. Ostroumov, A. O. Shevchenko, A. B. Mironkov, and A. Ya. Kormer
- Subjects
cardiac allograft vasculopathy ,coronary intervention ,stent restenosis ,Surgery ,RD1-811 - Abstract
Aim of the study is to show the pathogenetic importance of myocardial revascularization and to estimate quantitatively effi ciency of the treatment of cardiac allograft vasculopathy after heart transplantation.Materials and methods. 30 percutaneous coronary interventions (PCI) were performed to recipients of heart transplant (8 men and 7 women, aged from 18 to 56 years), who were diagnosed with cardiac allograft vasculopathy by coronary angiography within the time period from 1,5 to 12 years after heart transplantation. Before revascularization and one week after tolerances to physical activity, volume characteristics of the left ventricle were defi ned and diastolic function of heart was estimated. Average term of observation after stenting was 35,5 ± 5,5 months.Results. Tolerance to physical activity (from 76,6 ± 8,5 to 116,9 ± 9,6 W), its duration (from 5,4 ± 2,2 to 8,5 ± 4,1 min) and rate pressure product – RPP (from 198 ± 15 to 247 ± 24 P < 0,05) increased. There was a restoration of diastolic function (Ve/Va from 0,57 ± 0,18 to 1,15 ± 0,2 P < 0,05). Signifi cant distinction in time frames of vasculopathy development, frequency and reasons of repeated interventions depending on age of patients is revealed. In the group of patients younger than 30 years of age (7 patients), the time interval between heart transplantation and vasculopathy development is twice shorter, than in more senior patient group, over 45 years old (8 patients). Young patients showed the expressed tendency to develop stent restenosis (20 coronary interventions).Conclusion. Dynamics in functional condition of the left ventricle as a result of revascularization confi rms the leading role of miocardial ischemia in pathogenesis of transplant insuffi ciency due to vasculopathy. The signifi cant factor infl uencing upon long-term result of coronary intervention is the age of the patient.
- Published
- 2014
- Full Text
- View/download PDF
48. Evaluation of the Predictive Value of CHA2DS2-VASc Score for In-Stent Restenosis.
- Author
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Yilmaz, Samet, Akboga, Mehmet Kadri, Aras, Dursun, and Topaloglu, Serkan
- Subjects
- *
INFLAMMATION , *SURGICAL stents , *MULTIPLE regression analysis , *PREDICTIVE tests - Abstract
The CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age 65-74 years, female gender) score is used to estimate thromboembolic risk in atrial fibrillation (AF). Its usefulness in predicting in-stent restenosis (ISR) is unknown. We evaluated the predictive value of the CHA2DS2-VASc score in AF-free patients who have undergone stent implantation. A total of 1350 patients who underwent coronary angiography and successful bare-metal stent implantation were analyzed. The CHA2DS2-VASc score was calculated before percutaneous coronary intervention, and the association between the score and ISR was investigated. Patients (n = 700; mean age: 61.4 [8.7] years, 63% men) were divided in 2 subgroups according to the presence of ISR; 265 of 700 patients had ISR. Mean CHA2DS2-VASc score was significantly higher in the ISR (+) group than the ISR (-) group (3.7 [1.8] vs 2.1 [1.4], P < .001). According to multivariate logistic regression analysis, diabetes, hyperlipidemia, smoking, stent length, and CHA2DS2-VASc score were independent predictors of ISR. In conclusion, the CHA2DS2-VASc score may be useful as a new and simple tool to predict ISR. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
49. Relationship between the extent of coronary artery disease and in-stent restenosis in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
- Author
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Yıldırım, Erkan, Çelik, Murat, Yüksel, Uygar Çağdaş, Buğan, Barış, Gökoğlan, Yalçın, Görmel, Suat, Yaşar, Salim, Koklu, Mustafa, İyisoy, Atila, and Barçın, Cem
- Abstract
Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
- Full Text
- View/download PDF
50. Is In-Stent Restenosis After a Successful Coronary Stent Implantation Due to Stable Angina Associated With TG/HDL-C Ratio?
- Author
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Kundi, Harun, Korkmaz, Ahmet, Balun, Ahmet, Cicekcioglu, Hulya, Kiziltunc, Emrullah, Gursel, Koray, Cetin, Mustafa, Ornek, Ender, and Ileri, Mehmet
- Subjects
- *
ANGINA pectoris , *CORONARY arteries , *HIGH density lipoproteins , *LIPOPROTEINS , *REGRESSION analysis , *SURGICAL stents , *TRIGLYCERIDES , *PROPORTIONAL hazards models - Abstract
We examined the impact of the preprocedural triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio on risk of in- stent restenosis (ISR). Patients with typical anginal symptoms and/or positive treadmill or myocardial perfusion scintigraphy test results who underwent successful coronary stent implantation due to stable angina were examined; 1341 patients were enrolled. The hospital files of the patients were used to gather data. Cox regression analysis showed that the TG/HDL-C ratio was independently associated with the presence of ISR (P < .001). Moreover, diabetes mellitus (P = .007), smaller stent diameter (P = .046), and smoking status (P = .001) were also independently associated with the presence of ISR. Using a cutoff of 3.8, the TG/HDL-C ratio predicted the presence of ISR with a sensitivity of 71% and a specificity of 68%. Also, the highest quartile of TG/HDL-C ratio had the highest rate of ISR (P < .001). Measuring preprocedural TG/HDL-C ratio, in fasting or nonfasting samples, could be beneficial for the risk assessment of ISR. However, further large-scale prospective studies are required to establish the exact role of this simple, easily calculated, and reproducible parameter in the pathogenesis of ISR. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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