Coronary Restenosis: Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Coronary Vessels: The veins and arteries of the HEART.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Coronary Disease: An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.Recurrence: The return of a sign, symptom, or disease after a remission.Coronary Artery Disease: Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to IMMUNOPHILINS. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties.Drug-Eluting Stents: Stents that are covered with materials that are embedded with chemicals that are gradually released into the surrounding milieu.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Coronary Stenosis: Narrowing or constriction of a coronary artery.Swine: Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Angioplasty, Balloon: Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.Coronary Thrombosis: Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Graft Occlusion, Vascular: Obstruction of flow in biological or prosthetic vascular grafts.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Coronary Aneurysm: Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.Ultrasonography, Interventional: The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Tunica Intima: The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Percutaneous Coronary Intervention: A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.Coronary Occlusion: Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.Beta Particles: High energy POSITRONS or ELECTRONS ejected from a disintegrating atomic nucleus.Hyperplasia: An increase in the number of cells in a tissue or organ without tumor formation. It differs from HYPERTROPHY, which is an increase in bulk without an increase in the number of cells.Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.Atherectomy, Coronary: Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.Platelet Aggregation Inhibitors: Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.Iridium Radioisotopes: Unstable isotopes of iridium that decay or disintegrate emitting radiation. Ir atoms with atomic weights 182-190, 192, and 194-198 are radioactive iridium isotopes.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Coronary Care Units: The hospital unit in which patients with acute cardiac disorders receive intensive care.Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues.Muscle, Smooth, Vascular: The nonstriated involuntary muscle tissue of blood vessels.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful.Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).Carotid Stenosis: Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)Vascular Patency: The degree to which BLOOD VESSELS are not blocked or obstructed.Angioplasty: Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.Neointima: The new and thickened layer of scar tissue that forms on a PROSTHESIS, or as a result of vessel injury especially following ANGIOPLASTY or stent placement.Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Angina, Unstable: Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.Electrocardiography: Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.Coated Materials, Biocompatible: Biocompatible materials usually used in dental and bone implants that enhance biologic fixation, thereby increasing the bond strength between the coated material and bone, and minimize possible biological effects that may result from the implant itself.Angioplasty, Balloon, Laser-Assisted: Techniques using laser energy in combination with a balloon catheter to perform angioplasty. These procedures can take several forms including: 1, laser fiber delivering the energy while the inflated balloon centers the fiber and occludes the blood flow; 2, balloon angioplasty immediately following laser angioplasty; or 3, laser energy transmitted through angioplasty balloons that contain an internal fiber.Calcinosis: Pathologic deposition of calcium salts in tissues.Drug Implants: Small containers or pellets of a solid drug implanted in the body to achieve sustained release of the drug.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Prosthesis Design: The plan and delineation of prostheses in general or a specific prosthesis.Arterial Occlusive Diseases: Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.Paclitaxel: A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death.Endarterectomy, Carotid: The excision of the thickened, atheromatous tunica intima of a carotid artery.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Dogs: The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Cineangiography: Motion pictures of the passage of contrast medium through blood vessels.Ticlopidine: An effective inhibitor of platelet aggregation commonly used in the placement of STENTS in CORONARY ARTERIES.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Coronary Artery Bypass, Off-Pump: Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called ENDARTERECTOMY.Saphenous Vein: The vein which drains the foot and leg.Angiography: Radiography of blood vessels after injection of a contrast medium.Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.Aspirin: The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Metals: Electropositive chemical elements characterized by ductility, malleability, luster, and conductance of heat and electricity. They can replace the hydrogen of an acid and form bases with hydroxyl radicals. (Grant & Hackh's Chemical Dictionary, 5th ed)Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Vasodilation: The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.Ultrasonography, Doppler, Duplex: Ultrasonography applying the Doppler effect combined with real-time imaging. The real-time image is created by rapid movement of the ultrasound beam. A powerful advantage of this technique is the ability to estimate the velocity of flow from the Doppler shift frequency.Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.Arteriosclerosis: Thickening and loss of elasticity of the walls of ARTERIES of all sizes. There are many forms classified by the types of lesions and arteries involved, such as ATHEROSCLEROSIS with fatty lesions in the ARTERIAL INTIMA of medium and large muscular arteries.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.Heart: The hollow, muscular organ that maintains the circulation of the blood.Swine, Miniature: Genetically developed small pigs for use in biomedical research. There are several strains - Yucatan miniature, Sinclair miniature, and Minnesota miniature.

Serial intravascular ultrasound analysis of the impact of lesion length on the efficacy of intracoronary gamma-irradiation for preventing recurrent in-stent restenosis. (1/1466)

BACKGROUND: The relation between lesion length and effectiveness of brachytherapy is not well studied. METHODS AND RESULTS: We compared serial (postintervention and follow-up) intravascular ultrasound findings in 66 patients with native coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy delivered 2 mm away from the radiation source). Patients were enrolled in the Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47 mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and source-to-target (intravascular ultrasound catheter to external elastic membrane) distances were measured. Postintervention stent areas were larger in WRIST and smaller in Long WRIST patients (P:<0.0001). At follow-up, maximum IH area significantly increased in both WRIST and Long WRIST patients (P:<0.0001 for both), but this increase was greater in Long WRIST patients (P:=0.0006). Similarly, minimum lumen cross-sectional area significantly decreased in both WRIST and Long WRIST patients (P:<0.05 and P:<0.0001, respectively), but this decrease was more pronounced in Long WRIST patients (P:=0.0567). The maximum source-to-target distance was longer in Long WRIST than in WRIST, and it correlated directly with ISR length (r=0.547, P:<0.0001). Overall, the change in minimum lumen area and the change in maximum IH area correlated with the maximum source-to-target distance (r=0.352, P:=0.0038 and r=0.523, P:<0.0001 for WRIST and Long WRIST, respectively). The variability (maximum/minimum) in IH area at follow-up also correlated with the maximum source-to-target distance (r=0.378, P:<0.0001). CONCLUSIONS: Brachytherapy may be less effective in longer ISR lesions because of the greater variability and longer source-to-target distances in diffuse ISR.  (+info)

Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. (2/1466)

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.  (+info)

Oral anticoagulant therapy during and after coronary angioplasty the intensity and duration of anticoagulation are essential to reduce thrombotic complications. (3/1466)

BACKGROUND: In the randomized Balloon Angioplasty and Anticoagulation Study (BAAS), the addition of oral anticoagulants to aspirin significantly reduced early and late events after coronary angioplasty. However, bleeding episodes were increased. The present report studied the intensity and the duration of anticoagulation as predictors of thrombotic and bleeding events. METHODS AND RESULTS: A total of 530 patients, 34% of whom received a stent, were treated with aspirin plus coumarins. Half of the patients were randomized to angiographic follow-up. The target international normalized ratio (INR) was 2.1 to 4.8 during angioplasty and 6-month follow-up. Thrombotic events were death, myocardial infarction, target lesion revascularization, and thrombotic stroke. Bleeding complications were hemorrhagic stroke, major extracranial bleeding, and false aneurysm. "Optimal" anticoagulation was defined as an INR in the target range for at least 70% of the follow-up time. There were 17 early thrombotic events (3.2%), 7 early bleeding episodes (1.3%), and 10 false aneurysms (1.9%). The incidence rate for both early thrombotic and bleeding events was lowest in patients in the target range. A total of 61 late thrombotic events occurred (11.6%). Optimal anticoagulation was an independent predictor of late thrombotic events (relative risk, 0.33; 95% CI, 0.19 to 0.57) and was associated with a 0.21 mm (95% CI, 0.17 to 0.42) larger vessel lumen at 6 months. Late bleeding episodes (1.4%) were lowest in patients in the target range. CONCLUSIONS: Coumarins started before coronary angioplasty with a target INR of 2.1 to 4.8 led to the lowest procedural event rate, without an increase in bleeding episodes. During follow-up, optimal anticoagulation was associated with a decrease in the incidence of late events by 67% and a significant improvement in 6-month angiographic outcome.  (+info)

Relation of a common methylenetetrahydrofolate reductase mutation and plasma homocysteine with intimal hyperplasia after coronary stenting. (4/1466)

BACKGROUND: Hyperhomocysteinemia has been identified as an independent risk factor for coronary artery disease. Recent studies have shown that a common mutation (nucleotide 677 C-->T) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to mild hyperhomocysteinemia and, therefore, to the incidence of coronary artery disease. No information exists, however, regarding the association between the mutation of the MTHFR gene or plasma homocysteine levels and morphological analysis of coronary atherosclerosis using intravascular ultrasound. METHODS AND RESULTS: To examine the potential influence of MTHFR genotype and homocysteine on coronaryarteries morphologically, we screened 62 patients with 65 lesions that were treated with 93 Palmaz-Schatz stents. The plasma homocysteine levels in the patients with the TT genotype were not significantly higher than those in the patients with non-TT (CC+CT) genotypes (13.1 +/- 5.5 versus 11.5 +/- 3.1 mmol/L, P=0.16). Angiographic analysis showed that the percent diameter stenosis in the patients with the TT genotype was significantly greater than that in those with non-TT genotypes (43.7 +/- 17.8% versus 29.0 +/- 22.0%, P=0.015). Intravascular ultrasound analysis showed that the TT genotype was significantly associated with greater intimal hyperplasia area (5.70 +/- 1.94 versus 3.72 +/- 1.38 mm2, P=0.001). In multiple stepwise regression analysis, the number of the T alleles was the only independent predictor of intimal hyperplasia after intervention (r2=0.21, P=0.004). CONCLUSIONS: The homozygous mutant genotype of the MTHFR gene may increase the risk of in-stent restenosis more than does the normal homozygous or heterozygous genotype.  (+info)

Long-term effects of intracoronary beta-radiation in balloon- and stent-injured porcine coronary arteries. (5/1466)

BACKGROUND: The data on the long-term safety and efficacy of intracoronary beta-radiation in animal models are limited. METHODS AND RESULTS: A total of 30 coronary arteries in 15 swine were subjected to balloon or stent injury followed by beta-radiation from a centered 32P source (2000 cGy to 1 mm beyond lumen surface) or a sham radiation procedure. The animals received aspirin for 6 months and ticlopidine for 30 days. Five of the 10 animals subjected to radiation died (at 5 days, 7 days, 3 months [n = 2], and 4 months) as a result of layered, occlusive thrombus at the intervention site (3 stent and 2 balloon injury sites). No deaths occurred in the control group. In the surviving animals, balloon-injured and irradiated vessels showed a trend toward larger lumens than controls (2.15 +/- 0.17 versus 1.80 +/- 0.08 mm2, P=0.06) and larger external elastic lamina areas (3.32 +/- 0.21 versus 2.62 +/- 0.10 mm2, P=0.003). In the stent-injured vessels from surviving animals, lumen, neointimal, and external elastic lamina areas were 3.58 +/- 0.33, 3.16 +/- 0.35, and 8.12 +/- 0.42 mm2 for irradiated vessel segments; these values were not different from those in controls (3.21 +/- 0.15, 2.84 +/- 0.27, and 7.76 +/- 0.28 mm2, respectively). Histologically, healing was complete in most survivors, although intramural fibrin and hemorrhage were occasionally seen. CONCLUSION: In the long-term (6 month) porcine model of restenosis, the inhibition by intracoronary beta-radiotherapy of the neointimal formation that is known to be present at 1 month is not sustained. This lack of effect on neointimal formation after balloon and stent arterial injury is accompanied by subacute and late thrombosis that leads to cardiac death on a background of continuous aspirin but relatively brief ticlopidine treatment.  (+info)

Lipid peroxidation may predict restenosis after coronary balloon angioplasty. (6/1466)

The present study assessed whether lipid peroxidation in plasma might predict restenosis after coronary balloon angioplasty. A total of 87 patients, who had undergone successful coronary balloon angioplasty using standard techniques, were enrolled. Fasting blood samples before the intervention were measured for plasma levels of thiobarbituric acid reactive substances (TBARS, an indicator of lipid peroxidation). Angiography was carried out before and 15 min after angioplasty, and at follow-up (4 months after angioplasty), and evaluated using a quantitative approach. There were 23 patients with restenosis (group R) and 64 patients without restenosis (group N) after coronary balloon angioplasty. The plasma TBARS level (mean+/-SEM) of 4.3+/-0.1 micromol/L in group R was significantly higher than that of 3.2+/-0.1 micromol/L in group N (p<0.01). There were no significant differences in other parameters, including plasma lipid levels, between the 2 groups. The plasma level of TBARS positively correlated with lumen loss of the coronary artery at the time of follow-up angiography (r=0.57, p<0.01). Our results suggest that oxidative stress contributes to restenosis and indicate that an elevated plasma level of TBARS may be a reliable predictor of restenosis.  (+info)

Histopathologic evaluation of coronary artery thrombi obtained by directional coronary atherectomy in patients with restenosis-induced unstable angina pectoris. (7/1466)

The pathogenesis of unstable angina pectoris (UAP) following percutaneous transluminal coronary angioplasty (PTCA) or directional coronary atherectomy (DCA) has not been adequately investigated, so the present study aimed to determine whether thrombi are present in restenotic lesions. The study group comprised 14 patients (16 arterial branches) with angina pectoris in whom either PTCA or DCA was performed and who had developed UAP associated with restenosis, and who then underwent DCA of the restenosed lesion (R-UAP group). The control groups comprised individuals with UAP undergoing DCA with no prior history of PTCA or DCA (P-UAP group; n=29, 29 branches), patients with acute myocardial infarction (AMI group; n=34, 34 branches), and patients with stable angina pectoris (SAP group; n=31, 33 branches). The presence of thrombi was determined by light microscopy of histologic specimens. Thrombus was present in only 1 of the 16 (6.3%) branches in the R-UAP group. 21 of the 29 (72.4%) branches in the P-UAP group, and in 25 of the 34 (73.5%) in the AMI group. In the SAP group, it was detected in only 2 of the 33 (7.1%) branches. The incidence of thrombus was significantly lower in the R-UAP group than in the P-UAP group. In conclusion, the role of thrombus is limited in causing post-interventional UAP at restenosed sites.  (+info)

Intracoronary brachytherapy in the treatment of in-stent restenosis. Initial experience in Brazil. (8/1466)

Intracoronary brachytherapy using beta or gamma radiation is currently the most efficient type of therapy for preventing the recurrence of coronary in-stent restenosis. Its implementation depends on the interaction among interventionists, radiotherapists, and physicists to assure the safety and quality of the method. The authors report the pioneering experience in Brazil of the treatment of 2 patients with coronary in-stent restenosis, in whom beta radiation was used as part of the international multicenter randomized PREVENT study (Proliferation REduction with Vascular ENergy Trial). The procedures were performed rapidly and did not require significant modifications in the traditional techniques used for conventional angioplasty. Alteration in the radiological protection devices of the hemodynamic laboratory were also not required, showing that intracoronary brachytherapy using beta radiation can be incorporated into the interventional tools of cardiology in our environment.  (+info)

*Cardiology in Review

"Prevention of Coronary Restenosis". Caridology in Review. 7 (4): 219-231. doi:10.1097/00045415-199907000-00014. PMID 10423674. ...

*Bioresorbable stent

February 1988). "Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative ... 15 March 2008). "A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery ... 2008). "A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions ( ... 14 March 2009). "A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple ...

*Health effects of tobacco

"Impact of smoking on clinical and angiographic restenosis after percutaneous coronary intervention: another smoker's paradox ... Smoking can cause atherosclerosis, leading to coronary artery disease and peripheral arterial disease. ... decrease coronary flow velocity reserves, and reduce heart rate variability, potentially increasing the risk of heart attack.[ ... "Smoke-free legislation and hospitalizations for acute coronary syndrome". The New England Journal of Medicine. 359 (5): 482-91 ...

*Endothelial dysfunction

"Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis". ... In the coronary circulation, angiography of coronary artery responses to vasoactive agents may be used to test for endothelial ... specificity to diagnose coronary artery disease when compared against the gold standard, acetylcholine angiogram.[10] This ... Sirolimus eluting stents were previously used because they showed low rates of in-stent restenosis, but further investigation ...

*Everolimus

... is used in drug-eluting coronary stents as an immunosuppressant to prevent restenosis. Abbott Vascular produce an ...

*MMP3

"Effect of the stromelysin-1 promoter on efficacy of pravastatin in coronary atherosclerosis and restenosis". The American ... Lopid Coronary Angiography Trial". Atherosclerosis. 139 (1): 49-56. doi:10.1016/S0021-9150(98)00053-7. PMID 9699891. de Maat MP ... such as progressive coronary atherosclerosis. The -1171 5A/6A variant has also been associated with congenital anomalies such ... "Progression of coronary atherosclerosis is associated with a common genetic variant of the human stromelysin-1 promoter which ...

*Sean P. Pinney

Anti-HLA antibodies are associated with restenosis after percutaneous coronary intervention for cardiac allograft vasculopathy ... Balloon dilatation of coronary sinus spasm during placement of a biventricular pacing lead. Circulation 2005; 111:e304-5. McKay ... Anterior myocardial infarction, acute aortic dissection and anomalous coronary artery. J Interven Cardiol 2002; 15:293-296. ...

*Trapidil

Reduces Restenosis After Percutaneous Transluminal Coronary Angioplasty. Results of the Randomized, Double-Blind STARC Study". ...

*Neointimal hyperplasia

... is the major cause of restenosis after percutaneous coronary interventions such as stenting or ... P radioactive β-emitting stents were used in coronary artery lesions with results showing inhibition of neointimal hyperplasia ... Shah, P.K. (2003). Inflammation, neointimal hyperplasia, and restenosis: as the leukocytes roll, the arteries thicken. ... Angioplasty Drug-eluting stent Restenosis Stent Kleinedler, J.J. (2012). Novel nanocomposite stent coating releasing ...

*Reviparin sodium

... and early clinical experience with reviparin-sodium for prevention of restenosis after percutaneous transluminal coronary ... Reduction of Restenosis After PTCA, Early Administration of Reviparin in a Double-Blind Unfractionated Heparin and Placebo- ... in percutaneous transluminal coronary angioplasty. Results of a randomized, double-blind, unfractionated heparin and placebo- ... Prophylaxis of acute thrombotic events after percutaneous transluminal coronary angioplasty (PTCA) Kakkar VV, Cohen AT, Mohamed ...

*Alan Heldman

2001). "Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis". ... His clinical interests include high risk and complex coronary intervention, treatment of hypertrophic cardiomyopathy, including ... could prevent restenosis. His research interests include delivery of stem cells to the heart for repair of myocardial ...

*Paclitaxel

... is used as an antiproliferative agent for the prevention of restenosis (recurrent narrowing) of coronary and ... 2001). "Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis" (PDF). ... Paclitaxel drug eluting coated stents for coronary artery placement are sold under the trade name Taxus by Boston Scientific in ...

*Interleukin 36 receptor antagonist

2004). "IL-1 cluster genes and occurrence of post-percutaneous transluminal coronary angioplasty restenosis: a prospective, ...

*Nikotin - Wikipedija, prosta enciklopedija

"Impact of Smoking on Clinical and Angiographic Restenosis After Percutaneous Coronary Intervention". Circulation 104 (7): 773. ...

*Brachytherapy

... can be used in the treatment of coronary in-stent restenosis, in which a catheter is placed inside blood vessels ... for the treatment of coronary in-stent restenosis. The dose rate of brachytherapy refers to the level or 'intensity' with which ... "Guidelines for Percutaneous Coronary Interventions: the Task Force for Percutaneous Coronary Interventions of the European ... In treating In-stent restenosis (ISR) Drug Eluting stents (DES) have been found to be superior to Intracoronary Brachytherapy ( ...

*Zotarolimus

... development of thrombosis which impedes the efficiency of coronary stents, haemorrhagic and restenosis complications are ... Restenosis is typically described by clinical trials in a binary approach, otherwise known as "binary restenosis" or just " ... The first human coronary stent implantation was first performed in 1986 by Puel et al. However, there are complications ... Coronary stents reduce early complications and improve late clinical outcomes in patients needing interventional cardiology. ...

*MTOR inhibitors

Since then, rapamycin has also shown to be effective for preventing coronary artery re-stenosis and for the treatment of ... In 2003, the U.S. Food and Drug Administration approved sirolimus-eluting coronary stents, which are used in patients with ... "CYPHER™ Sirolimus-eluting Coronary Stent - P020026". Food and Drug Administration. Retrieved 25 September 2012. "Torisel". ... narrowing of coronary arteries, or so-called atherosclerosis. Recently rapamycin has shown effective in the inhibition of ...

*Stent

It was used as a scaffold to prevent the vessel from closing and to avoid restenosis in coronary surgery-a condition where scar ... The use of these bare-metal stents helped reduce the incidence of restenosis from 30-40% in coronary surgery to 20-30%.[ ... The first use of a coronary stent is typically attributed to Jacques Puel and Ulrich Sigwart when they implanted a stent into a ... As Ariel Roguin describes in his paper "Stent: The Man and Word Behind the Coronary Metal Prosthesis", the current acceptable ...

*Daljeet Singh Gambhir

... he is known to have established a radiation therapy department at the hospital for the treatment of coronary restenosis. Later ... Gambhir, known to have specialized in non-surgical coronary interventional techniques, is reported to have performed over ... he is reported to have performed over 10,000 coronary interventions. The Government of India awarded him the fourth highest ...

*Sirolimus

The antiproliferative effect of sirolimus has also been used in conjunction with coronary stents to prevent restenosis in ... A sirolimus-eluting coronary stent was marketed by Cordis, a division of Johnson & Johnson, under the tradename Cypher. However ... "Cypher Sirolimus-eluting Coronary Stent". Cypher Stent. Retrieved 1 April 2008. Seto B (November 2012). "Rapamycin and mTOR: a ... Sirolimus, also known as rapamycin, is a macrolide compound that is used to coat coronary stents, prevent organ transplant ...

*Healthcare in Kosovo

... which is used for treatment of re-stenosis of coronary arteries. This is a breakthrough for Kosovo's medicine and the first ... Many of the newest treatments for coronary heart disease are performed within "Heart Hospital "EDA" through minimally invasive ... coronary artery stenting, ECG monitoring, and ECHO monitoring. Their doctors are currently participating at the worldwide ...

*Phosphorylcholine

... to prevent the occurrence of coronary artery restenosis. The first application of this approach for use on stents evolved from ... This will dilate the diameter of the coronary artery and keep it fixed in this phase so that more blood flows through the ... Drug-eluting stents (DES) are used by interventional cardiologists, operating on patients with coronary artery disease. The ... Analysis of a phosphorylcholine-based polymer coating on a coronary stent pre- and post-implantation, Biomaterials 23 (2002), ...

*Ticlopidine

"A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis ... Ticlopidine is FDA approved for the prevention of strokes and, when combined with aspirin, for patients with a new coronary ... Research initially showed that it was useful for preventing strokes and coronary stent occlusions. However, because of its rare ... 1996). "A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents". N ...

*Julie Campbell (vascular biologist)

This process is undergoing pre-clinical trials in humans and may be used to treat patients suffering coronary heart disease, ... This showed that current strategies to prevent restenosis after angioplasty of blocked arteries may have been targeted in the ... This 'Grow Your Own Arteries' technique is helping patients survive coronary heart disease, renal failure and other life- ... have potential use as access fistulae for haemodialysis patients and as coronary artery bypass grafts. She has used the same ...

*Radiation therapy

... coronary artery disease, heart arrhythmia and peripheral artery disease. Radiation-induced fibrosis, vascular cell damage and ... vascular restenosis, and heterotopic ossification. The use of radiation therapy in non-malignant conditions is limited partly ...
In 2001, when Morice et al. (1) presented the initial results of RAVEL (The Randomized Study With the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patients With De Novo Native Coronary Artery Lesions), showing 0% angiographic restenosis 6 months after implantation of a sirolimus-eluting stent, very few people would have envisaged that more than 10 years later, there would be a need for a trial to evaluate the best treatment strategy for drug-eluting stent (DES) in-stent restenosis (ISR).. Although widespread use of DES (versus bare-metal stents [BMS]), advances in stent design, and greater operator experience have all significantly reduced the incidence of restenosis and resultant target vessel revascularization (2), a low rate of ISR continues to exist and it is not benign. Outcomes are even poorer for those with DES compared with individuals presenting with BMS-ISR (3).. There are several treatment options for DES-ISR (e.g., repeat percutaneous coronary ...
Background: Differences in restenosis pattern and timing between bare-metal stent and drug-eluting stent (DES) have been reported. However, little is known about the effect of the type of DES on restenosis pattern and timing.. Methods: From November 2002 to August 2010, 6676 consecutive patients were treated with sirolimus-eluting stent (SES: 6321 lesions), paclitaxel-eluting stent (PES: 1520 lesions), zotarolimus-eluting stent (ZES: 599 lesions), everolimus-eluting stent (EES: 924 lesions), and biolimus-eluting stent (BES: 288 lesions), and underwent midterm follow-up coronary angiography (f/u CAG) at 8 months after implantation. Of these, patients without restenosis underwent late f/u CAG at 12 months after midterm f/u. We defined early restenosis as restenosis at midterm f/u and late restenosis as restenosis at late f/u without early restenosis. Restenosis patterns were classified into two groups according to Mehran classification: focal (pattern I) and diffuse (pattern II, III, ...
The principal findings of the ISAR-DESIRE 2 study are that in cases of DES restenosis occurring within a SES: 1) the implantation of a second DES is feasible and safe; 2) a strategy of either repeat SES implantation or switch to a PES is associated with comparable anti-restenotic efficacy; and 3) the neointimal inhibition observed with repeat SES implantation is somewhat lower than expected, indicative perhaps of the existence of some degree of drug hyporesponsiveness at an individual patient level.. The widespread adoption of DES therapy coupled with an overall increase in the number of PCI procedures has generated significant absolute numbers of patients presenting with DES restenosis (2). Clinically, the treatment of these DES restenotic lesions seems to be associated with slightly higher rates of recurrent restenosis than that observed after treatment of bare-metal stent restenosis. For example, the use of DES to treat bare-metal stent restenosis has been associated with repeat TLR rates at ...
1. The patient has an in-stent restenosis of , 50% (by subjective angiographic determination of the minimal luminal diameter compared to the distal reference diameter) within a native coronary artery which has previously undergone stent placement ( 4 weeks). Lesions must meet ISR Classification I-III.. 2. The patient has a history, signs of, or laboratory studies that suggest coronary ischemia attributable to the target stenosis. The diagnosis of angina pectoris is defined by Canadian Cardiovascular Society Classification (CCS I, II, III, or IV) OR unstable angina pectoris (Braunwald Classification B&C, I-II) OR patients with documented silent ischemia;. 3. The study target lesion must be located in an in-stent restenotic native coronary artery measuring , 2.75mm and 3.5mm in diameter and , 15mm and 40mm in length to allow treatment with a maximum of three 18mm stents. The target lesion must have undergone coronary interventional treatment , 4 weeks previously. Patients with one or more prior ...
Drug-eluting balloon for in-stent restenosis Yin Chen, Shilian Hu, Lei Wu To the Editor: We read with interest the meta-analysis by Indermuehle A et al which reported that drug-eluting balloon (DEB) appears to show great promise for in-stent restenosis (ISR), and could reduce the risk for major adverse cardiac events (MACE) compared with plain balloon angioplasty (BA)or implantation of drug-eluting stent (DES) in the treatment of ISR (1).Coronary ISR, happened after coronary stent implantation, continued to be a major problem. The authors raised a critical concern assessing the effectiveness of DEB, and long-term outcomes were adequately discussed in the article. Actually, for the PACCOCATH (Treatment of ISR by Paclitaxel Coated PTCA Balloon) trial, the short-term outcomes were not identified in the meta- analysis (2, 3), and the subgroup analysis according to control group (BA or DES) was only adopted for late lumen loss. DEB appears to be more effective in the reduction of binary restenosis ...
Background: The aim of this study was to investigate the efficacy and safety of paclitaxel-coated balloon (PCB) for the treatment of the bare-metal stent restenosis (BMS-ISR) and drug-eluting stent restenosis (DES-ISR).. Methods: This study was a prospective, multicenter, randomized (2:1) trial conducted in 208 patients with 213 in-stent restenosis lesions (BMS-ISR; 123 lesions, DES-ISR; 90 lesions) at 13 centers in Japan. Patients were randomly assigned to PCB group (PCB group, 137 patients with 142 lesions) or conventional balloon angioplasty group (BA group, 71 patients with 71 lesions). The primary endpoint was target vessel failure (TVF) at 6-month follow-up.. Results: Clinical and angiographic follow-up 6 months after intervention was performed in 207 patients (99.5%) with 208 lesions (97.7%). TVF was noted in 6.6% of PCB group and 31.0% of BA group (p,0.001). Recurrent restenosis occurred in 4.3% of PCB group and 31.9% of BA group (p,0.001). Late lumen loss was lower in PCB group than in ...
Restenosis is the recurrence of stenosis, a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage and subsequently become renarrowed. This is usually restenosis of an artery, or other blood vessel, or possibly a vessel within an organ. Restenosis is a common adverse event of endovascular procedures. Procedures frequently used to treat the vascular damage from atherosclerosis and related narrowing and renarrowing (restenosis) of blood vessels include vascular surgery, cardiac surgery, and angioplasty. When a stent is used and restenosis occurs, this is called in-stent restenosis or ISR. If it occurs following balloon angioplasty, this is called post-angioplasty restenosis or PARS. The diagnostic threshold for restenosis in both ISR or PARS is ≥50% stenosis. If restenosis occurs after a procedure, follow-up imaging is not the only way to initially ...
The use of SES has been shown in randomised clinical trials to result in an in-stent lumen loss of −0.01 to 0.20 mm for de novo coronary lesions.6,7,8,9,10 Slightly higher lumen loss ranging from 0.12 (0.41) to 0.21 (0.62) mm has been reported in small registries with the use of SES for ISR lesions.21,22 In this study in-stent lumen loss in the SES group was 0.30 (0.49) mm if patients with failed IRT were included and 0.23 (0.41) mm if only patients with SES used for first time ISR were analysed. Thus, the results are comparable with those of previous studies on the use of SES for ISR.. It is important to note that not all ISR lesions have a similar risk of recurrence.13 This has to be considered if angiographic and clinical follow up results for different treatment modalities for ISR are compared. Most studies analysing the procedural and follow up results of different treatment strategies for ISR were not randomised or matched comparisons.23 In this study ISR lesions treated with SES were ...
The use of drug-eluting stents and of drug-coated balloons have mitigated the prevalence of in-stent restenosis, however in-stent remains a problem that continues to affect the long-term outcomes of femoro-popliteal endovascular therapy. This paper will provide an overview on the latest data with regard to the treatment of femoro-popliteal in-stent restenosis.. ...
Treatment of in-stent restenosis.: Although in-stent restenosis is the result of neointimal hyperplasia, mechanical problems (e.g. stent underexpansion) that oc
restenosis - MedHelps restenosis Center for Information, Symptoms, Resources, Treatments and Tools for restenosis. Find restenosis information, treatments for restenosis and restenosis symptoms.
The concept of systemic pharmacological treatment to reduce inflammation after stenting has been applied in many preclinical and clinical studies with varying success.3,4,18,19 Because of a lack of drug specificity requires high dosages to achieve sustained effects on neointimal growth, systemic side-effects are of major concern and have hindered the general acceptance of systemic pharmacological approaches to prevent restenosis. Steroids have been proven to be effective in reducing neointimal growth in preclinical and clinical settings2-4,20 but, nonetheless, systemic administration of glucocorticoids to prevent in-stent restenosis could not gain acceptance in routine clinical practice because of a lack of efficacy at concentrations low enough to avoid the hazard of steroid side-effects.. The targeted use of pharmacologically modified steroids with high affinity for sites of arterial injury, as demonstrated by our study, might be a valuable approach to effectively prevent restenosis at dosages ...
Objective: Drug-eluting stents (DES) have reduced restenosis rates compared with bare-metal stents. P27 and P53 play important roles in the signal transduction leading to neointimal growth inhibition and induction of apoptosis of smooth muscle cells due to rapamycin and paclitaxel. We hypothesized that genetic variants of P27 and P53 influence the development of restenosis and the clinical outcome of patients receiving DES. Methods: Polymorphisms in the genes encoding for P27 and P53 were tested for their association with restenosis and major adverse cardiac events. P27 C-79T and P53 G72C polymorphism genotypes were determined in a series of 433 consecutive patients receiving DES. Follow-up angiography after 6 months was performed in 87% of the patients. Genotyping was performed with PCR-based methods. Results: For patients with the respective P27 C-79T and P53 G72C genotypes, the angiographic restenosis rates were between 5.0 and 22.0%, and the clinical restenosis rates were between 0.0 and ...
Results of the ISAR-DESIRE 4 Trial Presented at TCT 2015 SAN FRANCISCO - October 14, 2015 - Results from the ISAR-DESIRE 4 trial indicate that use of a scoring balloon plus a paclitaxel-coated balloon (PCB) was angiographically superior to a paclitaxel-coated balloon alone for the treatment of restenosis within limus-eluting stents.. Findings from study were presented today at the 27th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the worlds premier educational meeting specializing in interventional cardiovascular medicine.. Restenosis after drug-eluting stent implantation (DES) in patients with coronary artery disease occurs in up to 5 to 10% of cases and the most appropriate treatment strategy remains unclear. Drug-coated balloons (DCB) are novel devices that can effectively treat in-stent restenosis. Scoring balloon (SCB) devices prevent balloon slippage and enhance local plaque disruption during ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
The argument went that the same would likely be true for reversed saphenous veins. Randomized trials in the past supported this notion. RRISC (2006) showed that angiographic restenosis occurred more frequently with BMS (33 percent vs. 14 percent with DES), but there were only 75 patients in the trial. Notably, there was no difference in major adverse cardiovascular events (MACE) at 32 months. The SOS trial (2009 with 80 patients) supported this finding with a 51 percent vs. 9 percent angiographic restenosis rate at 12 months with BMS and DES respectively. Target vessel failure also occurred more frequently with BMS at 35 months.. More recent trials, ISAR CABG and BASKET-SAVAGE (2011 and 2016 respectively) also found DES to be superior. These trials used composite endpoints of death or cardiac death, target lesion or target vessel revascularization and myocardial infarction as endpoints. That makes comparison of actual restenosis rates difficult. Nonetheless, the number of patients was larger and ...
At three-year follow-up target lesion revascularisation was significantly less in the 192Ir group (15.4% vs 48.3%; P ,0.01). The dichotomous restenosis rate at 3 years was also significantly less in 192Ir patients (33% vs 64%; P ,0.05). No events occurred at either the 6 months or 3 year follow-up to suggest an adverse effect of vascular radiotherapy. ...
The FDA approved Medtronics IN.PACT Admiral drug-coated balloon Sept. 13 to treat in-stent restenosis in patients with peripheral artery disease.
In the REMEDEE trial, the Combo stent was found to be noninferior to the PES with respect to 9-month angiographic in-stent LLL and thereby met its primary endpoint. The observed in-stent LLL of 0.39 mm for the Combo stent was greater than that reported for conventional SES, where Cypher (Cordis, Miami Lakes, Florida) LLL values have been reported up to 0.24 mm, including diabetic patients (13-15). These angiographic results are in line with the expected capture of circulating EPCs by the CD34 antibody, creating a fast and complete layer of cells leading to the covering of the stent struts. Experimental data have shown that the abluminal release of sirolimus by the Combo stent results in a similar effective dosage in the stented arterial wall, as with the omnidirectional release by the SES, yet with a drastically reduced release to the circulation (6).. Angiographic LLL has been used as a surrogate for DES efficacy in preventing angiographic restenosis and the need for repeat TLR (16,17). A ...
This study demonstrated that rosiglitazone significantly reduced restenosis rate in the 6 months after coronary stenting in the type 2 diabetic patients. These effects were independent of glycemic control, since there were no significant relationships between the restenosis percentage and the changes in glucose concentrations and because the glycemic indexes were similar in the two groups, either at the baseline or at the follow-up angiography.. Because the proliferations of neointimal tissue and/or the medial vascular smooth muscle cells (VSMCs) are pivotal to the pathophysiology of a postintervention restenosis (20,21), inhibiting cellular proliferation for preventing an in-stent restenosis is a rational strategy. Although numerous therapies, including mechanical or pharmacological approaches, to block or inhibit the pathological processes of vascular proliferation have been studied, clinical trials have generally failed to recapitulate the efficacy documented in animal studies (8-11). ...
ISR can be defined clinically or angiographically. Definitions ISR can be defined clinically or angiographically. Clinically, it is defined as the presentation of recurrent ischaemia Angiographically, ISR is the presence of >50% diameter stenosis in the stented segment. 50%-70% : moderate %-99% : severe Teirstein PS, N Engl J Med, 1997
In the initial evaluation, there was a significant benefit for use of the LifeStent. Results from the 12-month analyses indicate that although there was no difference in freedom from major adverse cardiac events between the control and test group, primary patency and freedom from target lesion revascularisation (TLR) were significantly increased in the patients treated with the LifeStent. In addition, results from the 24-month follow-up indicate that freedom from TLR in patients treated with the LifeStent is almost double that of patients treated with angioplasty alone. However, although the results from patients treated with the LifeStent were better overall, Scheinert added that an angioplasty-only strategy "has a role in patients with less complex lesions" such as those that are shorter or less-severely calcified.. ...
Vinay Malhotra, MD, a cardiologist at the Cardiac Study Center inTacoma, Wash., evaluated in-stent restenosis (ISR) and chronic totalocclusions (CTO) in the lecture series
A medical stent is sized for placement in a ureter. The stent includes a first section which includes a first material, defines a lumen, and includes a first coil completing at least one revolution. A second section of the stent includes a second material, defines a lumen, and includes a second coil completing at least one revolution. A third section defines a lumen and is located between the first and second sections. The third section includes a co-extrusion of the first and second materials. One of the first or second sections is harder than the other section.
Trouvaille Stent Équipement RFP For Sale, ou Wanted du plus grand marché médical déquipement des mondes. DOTmed.com a un des plus grands choix de nouveau, utilisés, et refourbis Stent équipement sur le marché.
واشنطن، العاصمة ــ في ظل الاضطرابات في أوكرانيا، ومراقبة الولايات المتحدة وروسيا لتحركات كل منهما الأخرى بحذر، يبدو العالم وكأنه على شفا مواجهة طويلة أشبه بالحرب الباردة. ولكن هل هذا صحيح حقا؟. لقد قامت روسيا، التي تتهم الغرب بدعم انقلاب قام به "فاشيون" و"إرهابيون" في كييف، بضم شبه جزيرة القرم، واختبرت صاروخاً باليستياً عابراً للقارات، واحتفظت بحق التدخل عسكرياً في شرق أوكرانيا لحماية السكان الروس هناك. وفرضت الولايات المتحدة عقوبات على روسيا واعتبرت ضم شبه جزيرة القرم تصرفاً غير قانوني. ولكنها دعت أيضاً إلى التعاون لحل الموقف سلمياً وأعلنت أن ...
The FAIR trials objective was to assess safety and efficacy of angioplasty with drug-eluting balloon vs. standard angioplasty for the treatment of symptomatic superficial femoral artery in-stent restenosis. The primary endpoint was binary (≥50%) restenosis rate at six months as assessed by duplex ultrasound corelab adjudication (PSVR≥2.4). The secondary endpoints were primary angiographic success (,50% residual stenosis), six-month recurrent in-stent restenosis (≥70%) and 12-month recurrent in-stent restenosis (≥50%), six- and 12-month clinically-driven target lesion revascularisation, and clinical/haemodynamic assessment (walking distance, ankle brachial index, Rutherford category) at one, six and 12 months. The investigators also assessed the major adverse vascular events (MAVE) at 12 months.. Patients who had Rutherford class 2-4 lesions and superficial femoral artery in-stent restenosis between 70-100% as assessed by duplex ultrasound were included. Further, to be included, patients ...
Hello and welcome to the December issue of Vascular Disease Management. I have chosen to comment on Deepika Kalisetta and colleagues case report on Balloon Assisted Dislodgement of a Trapped Directional Atherectomy Catheter (the Ocelot device) During Treatment of In-Stent Restenosis (ISR).. Stenting of femoropopliteal arterial obstructive lesions has been demonstrated to result in higher primary patency than standard balloon angioplasty. Stenting is also routinely utilized to treat flow-limiting dissections following PTA and atherectomy. Therefore, stenting is commonly utilized in treating symptomatic femoral and popliteal arterial obstructions. Unfortunately, restenosis and reocclusion are common following stenting. Whereas stent grafts tend to develop recurrent stenosis only at the edge of the stents, standard nitinol self-expanding stents often develop diffuse in-stent restenosis secondary to neointimal hyperplasia and reocclusion when there is superimposed thrombus. Stent restenosis can ...
Boston Scientifics Jetstream atherectomy system has received CE mark for a new in-stent restenosis indication. This indication gives EU physicians "another safe and effective treatment option for in-stent restenosis, a disease state that has historically been challenging to treat with traditional therapies," says a Boston Scientific press release.. The indication is supported by data from the Jetstream-ISR feasibility study, in which the device demonstrated a strong safety profile, with zero device-stent interactions. The study included long, complex lesions (62% were TASC C&D). Six-month freedom from target lesion revascularisation was 86.2% with patency at 72%.. ...
196 of 205 patients assigned to treatment of placebo were followed clinically and 177 had repeat angiography. There was no difference between groups in the following: average age 61 years, 22% were women, 40% were smokers, 28% diabetics, lipids, homocysteine (11μm/L), or treatment with statins (71%), beta blockers (65%), and ACIi (35%), use of stents (50%). Treatment lowered homocysteine levels from 11.1 +/- 4.3μm/L to 7.2 +/- 2.4 μm/L. The rate of restenosis was significantly lower on treatment (19.6% vs 37.6%, p = 0.01) as was the need for target vessel revascularization (10.8% vs. 22.3%, p = 0.047). The followup minimal luminal diameter and percent stenosis was also significantly better in the folate group. There was no difference in other coronary events. The benefit was predominately in those with PTCA without stenting ...
In-stent restenosis has long remained the major limitation of coronary stenting. Recent randomized trials have shown that the use of drug-eluting stents (DES) markedly reduce the risk of in-stent restenosis following treatment of de novo lesions,1-4 even lesions at high risk for in-stent restenosis.5,6 Calcified lesions are often undilatable with conventional balloons and are a predictor of late in-stent thrombosis.7 Stent underexpansion is also associated with restenosis8 and in-stent thrombosis after successful DES implantati
Clinical trial for Transluminal | Coronary Restenosis | Percutaneous Coronary | Angioplasty , Effects of Celecoxib On Restenosis After Coronary Intervention and Evolution of Atherosclerosis Trial
PARIS--(BUSINESS WIRE)--May 16, 2012-- Physicians presented today at EuroPCR 2012 the results of two multicenter, randomized controlled trials, the BELLO and PACIFIER studies, each one showing statistically significant advantages of using an IN.PACT drug-eluting balloon from Medtronic, Inc. (NYSE: MDT) over a corresponding conventional treatment for coronary and peripheral artery disease.. Medtronic IN.PACT drug-eluting balloons received CE (Conformité Européenne) mark in 2008 and 2009 and are available in many countries around the world. They are not commercially available in the United States.. BELLO The physician-initiated BELLO (Balloon Elution and Late Loss Optimization) study enrolled 182 patients across 15 hospitals in Italy to evaluate the safety and effectiveness of the Medtronic IN.PACT Falcon(TM) drug-eluting balloon versus the Taxus drug-eluting stent (DES) from Boston Scientific Corp. in reducing late lumen loss in small-vessel coronary artery disease. With both devices eluting ...
A 93 patient randomised trial of a sirolimus-coated nitinol stent vs. the same, uncoated device in relatively long lesions (mean length 8.3 ± 4.5 cm) ended with high long-term efficacy of BMS: the two-year angiographic restenosis rate was 21% in both groups. Two-year target lesion revascularisation was very low overall and there was no significantly different restenosis between the BMS and the DES arm: 13% vs. 6% (15). Nevertheless, it could be expected that this figure was twice that of the BMS group, and the difference would have reached significant figures with a bigger sample size.. Polimer-free paclitaxel-coated DES implantation or balloon dilatation (PTA), debatable results: In a subsequent larger trial, 479 symptomatic patients were assigned to polimer-free paclitaxel-coated DES implantation or balloon dilatation (PTA) of femoro-popliteal stenoses with a mean length of 6.3 ± 4 cm. (16). Patients in the balloon arm were further randomised to BMS or DES during the intervention if balloon ...
Hellenic J Cardiol 2011; 52: Original Research Long-Term Results After Drug-Eluting Stent Implantation in Diabetic Patients According to Diabetic Treatment Vassilis Voudris, Panagiotis Karyofillis,
The principal findings from the present report, representing the final 5-year analysis from the TAXUS clinical trial development program, are that in patients undergoing PCI of a single de novo lesion of varying complexity, treatment with the slow-release PES versus an otherwise identical BMS resulted in: 1) significant 1-year reductions in ischemia-driven TLR and TVR in simple and complex patients and lesions, differences that were maintained throughout 5 years of follow-up, with no evidence of late catch-up apparent; 2) nonsignificant differences in the cumulative rates of all-cause mortality, cardiac mortality, MI, and cardiac death or MI at the end of the 5-year follow-up period; 3) an increase in the 5-year cumulative rate of stent thrombosis, which reached statistical significance when defined by the pre-specified protocol definition of stent thrombosis, but not by the ARC definite or probable definition; and 4) similar rates of cardiac death or MI and protocol-defined stent thrombosis ...
The problem of in-stent re-stenosis continues to be the principle factor limiting the durability of percutaneous arterial interventions. Pharmacologic solutions to the problem of neointimal hyperplasia have been used successfully in the coronary arteries in the form of drug-eluting stents. In the lower extremity, drug eluting stents are becoming more widely accepted and evidence now supports their efficacy in the periphery. As the technology evolves, the ability to deliver drug to an arterial segment without leaving behind metal scaffolding has become an appealing prospect. Based on studies in animal and human arteries, paclitaxel delivered to an artery via contrast medium or balloon surface provides enough drug concentration to impact the process of neo-intima formation. The favorable pharmacokinetics of drug elution via balloon allow the clinician to deliver effective concentrations of drug in reasonable inflation times without the need for stents. The results thus far are very encouraging in ...
12-month data from the RESTORE pilot clinical trial between December 2011 and July 2012 were also presented at TCT. The RESTORE trial was designed to evaluate safety and performance of the first generation ReZolve sirolimus-eluting bioresorbable coronary scaffold. Imaging results of patients treated with ReZolve who remained event free after treatment demonstrated a mean in-stent late loss of 0.29 mm. When imaging results for patients who had undergone retreatment for focal in-stent restenosis the mean in-stent late loss was 0.69 mm ...
A pooled analysis of safety data from Medtronics Endeavor clinical programme has affirmed the superior safety of the Endeavor drug-eluting coronary stent compared to the best-in-class Medtronic bare metal stent, Driver.
A stent is a small, expandable tube that can be inserted into a blood vessel and expanded using a small balloon during a procedure called angioplasty. A stent is used to open a narrowed or clotted blood vessel.. When the balloon inside the stent is inflated, the stent expands and presses against the walls of the artery. This traps any fat and calcium buildup against the walls of the artery and allows blood to flow through the artery. The stent helps prevent the artery from closing again (restenosis). It can also help prevent small pieces of plaque from breaking off and causing a heart attack or stroke.. To insert the stent, a flexible, thin tube (catheter) is passed through an artery in the groin or arm into the narrowed artery. Then the balloon inside the stent is inflated.. Some stents, called drug-eluting stents, are coated with a medicine to more effectively prevent restenosis. ...
Gene-eluting stents can have profound impact in the treatment of coronary restenosis, especially when the encoded protein can re-endothelialize the arterial lumen. In this study, we have examined gene...
CardioMind, Inc., a developer of stents for small, difficult-to-treat blood vessels, announced today that it has begun a First-in-Human clinical trial of its drug-eluting stent.
Terumo has received the CE mark for its Ultimaster Tansei drug-eluting stent. Building on the Ultimaster stent, a press release reports, the Ultimaster Tansei features optimised technology that will benefit clinicians and their patients worldwide.
Although the increased use of balloon expandable stents is a valuable contribution for diminishing the restenosis rate after PTCA 3, a number of papers reporting several severe complications have been published. The complications can be related to the site of percutaneous insertion (15% of all cases, 50% of which need surgical treatment 3,4 ) or the site of the coronary stent deployment, such as subacute stent thrombosis ( 3-5% in elective and 10-20% in emergency cases 4). In our case two complications were described: a peripheral one, a pseudoaneurysm, and a coronary one, an unsuccessful deployment of a balloon extended stent. The use of stents for lesions located in the proximal third of the LAD is a routine procedure. We also decided to use a stent in order to reduce the risk of restenosis. This type of stent is advanced across the lesion without a protective sheath. After placing the stent in the correct position, the balloon was expanded and unsuccessfully deployed, due to the fact that it ...
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A method for inhibiting restenosis is described. The method comprises implanting a stent in a patients vasculature and simultaneously delivering a restenosis-inhibiting medicine to the treatment site by adjuvant therapy.
An intravascular stent reduces the risk of restenosis due to stent implantation by using 17beta-estradiol as a vessel healing substance after implantation of an intravascular stent. The 17beta-estradiol coats at least a portion of the surface of the stent and is adhered to the stent with an adhesive layer containing DLC (
A mounting and transfer device and method for installing a stent on a delivery device that inserts the stent into a body lumen. The device includes a generally cylindrical mandrel for receiving and frictionally holding a stent, a handle at a first end of the mandrel and a guide rod extending axially from the second of the mandrel. The second end of the mandrel has a conical recess surrounding the guide rod exit. In use, a stent is placed on the mandrel, the distal end of the guide rod is fully inserted into a guide wire lumen at an end a delivery system such as a catheter and the stent is slid from the mandrel onto the balloon and crimped in place. A tube of heat shrinkable material may be placed over the stent on the mandrel and heat shrunk to lightly press against the stent. The tube and stent are transferred to the balloon and crimped. The tube protects the stent against damage during transfer and crimping and is easily removed thereafter since crimping reduces the outside diameter of the stent to
Angioplasty has completely transformed the treatment of coronary artery disease and is widely used, with more than 800,000 procedures performed worldwide per year. However, the enthusiasm for angiopla
A composite intraluminal device is deployable within a body vessel. The composite device includes an elongate radially expandable tubular stent having an interior luminal surface and an opposed exterior surface extending along a longitudinal stent axis. A stent cover is formed of unsintered ePTFE which is expandable. The stent cover is positioned about the stent so as to permit expansion of the cover upon the radial expansion of the stent.
The present invention is directed to a stent for use in a bifurcated body lumen having a main branch and a side branch. The stent comprises a radially expandable generally tubular stent body having proximal and distal opposing ends with a body wall having a surface extending therebetween. The surface has a geometrical configuration defining a first pattern, and the first pattern has first pattern struts and connectors arranged in a predetermined configuration. The stent also comprises a branch portion comprised of a second pattern, wherein the branch portion is at least partially detachable from the stent body.
The present invention is directed to a stent for use in a bifurcated body lumen having a main branch and a side branch. The stent comprises a radially expandable generally tubular stent body having proximal and distal opposing ends with a body wall having a surface extending therebetween. The surface has a geometrical configuration defining a first pattern, and the first pattern has first pattern struts and connectors arranged in a predetermined configuration. The stent also comprises a branch portion comprised of a second pattern, wherein the branch portion is at least partially detachable from the stent body.
A stent includes a first stent section, a second stent section, and at least one connecting member. The connecting member has a first end attached to the first stent section, a second end attached to the second stent section and a physically separable portion.
A patient that has had a kidney stent inserted will be able to eat normally and to have sex normally (if there is a thread attached to the stent then there cannot be any sex), but the patient will...
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Royal Copenhagen stent jsfigur #21675 *oprejst siddende bj rn* Royal Copenhagen stent jsfigur #21675 af Knud Kyhn i Sung glasur, 1. sortering, H. 18 ...
Stent Veterella je ur en k terapii trache ln ho kolapsu u ps . Zav d c syst m s komprimovan m stentem je ur en pro implantaci do stenotick pr du nice pod skiaskopickou nebo endoskopickou kontrolou.. ...
PENYAKIT jantung lazimnya dikaitkan dengan warga emas. Tetapi senarionya hari ini penyakit tersebut boleh menyerang tanpa mengira umur.Ini dapat dilihat dari se
Drug-eluting stents work as well as bare-metal stents at keeping blocked arteries open, according to a meta-analysis in the April 23 Archives of Internal Medicine. Additionally, drug-eluting stents dont increase the risk of death, and theyre more likely to prevent narrowing of the arteries than bare-metal stents. Researchers analyzed records from 11 clinical trials involving a total of 6,551 patients; approximately two-thirds had been fitted with drug-eluting stents and one-third with bare-metal stents. About a year after the stents were placed, there were no significant differences between groups in the risks of death, stent thrombosis, or heart attack recurrence. However, patients with drug-eluting stents required revascularization nearly half as often as those with bare-metal stents. The results, write the authors, "provide strong evidence of the beneficial effects" of drug-eluting stents compared with bare-metal stents. ...
TY - JOUR. T1 - Solid-state, pulsed-wave, mid-infrared coronary laser angioplasty in de novo versus restenosis lesions. T2 - Observations from a multicenter study. AU - Topaz, O.. AU - McIvor, M.. AU - De Marchena, Eduardo. PY - 1995/10/1. Y1 - 1995/10/1. N2 - The following is a study of the response of de novo versus restenosis coronary lesions to pulsed-wave, mid-infrared (holmium:YAG) laser assisted angioplasty. De novo lesions contain thrombi, cholesterol, and fibrosis, whereas restenotic lesions are composed of smooth muscle cells corresponding to injury caused by preceding balloon inflations. It is not known whether the different composition affects results of treatment by laser. In a clinical multicenter study, a mid-infrared, solid-state, pulsed-wave laser (holmium:YAG, 2.1 μm wavelength, 250-600 mJ/pulse, 5 Hz) was applied for revascularization of de novo and restenosis coronary lesions. Analysis of data was undertaken to document laser success, complications, and restenosis rate and ...
Despite the success of coronary stent implantations in the last decade, in-stent restenosis due to neointimal hyperplasia remains a problem to overcome. Neointimal hyperplasia is a vascular response to stent injury and mainly consists of proliferation of smooth muscle cells and deposition of extracellular matrix. Recently, local drug delivery has been advocated as a potential strategy to prevent in-stent restenosis. Unprecedented results have been obtained in early clinical studies on sirolimus-eluting and paclitaxel-eluting stents. Trials using various pharmaceutical coatings on different coronary stents are ongoing. More types of drug-eluting stents are expected on the market in the near future. Meanwhile, the evaluation of drug-eluting stents is entering the second phase in which the safety and efficacy in more complex lesion subsets and different clinical presentations are being investigated. Results including cost-benefit analyses are expected to have a tremendous impact on the practice of ...
OBJECTIVE: We sought to characterize the long-term outcomes of patients undergoing intracoronary brachytherapy using Beta- irradiation (Beta-BT). BACKGROUND: Beta-BT is effective in reducing angiographic restenosis as well as target vessel revascularization (TVR) in patients with in-stent restenosis (ISR) after bare-metal stenting (BMS). METHODS: 81 consecutive patients undergoing Beta-BT for ISR (irradiated length 32 [32-54] mm) after BMS in native vessels (n = 79) or saphenous vein grafts (n = 2) between 2001 and 2003 were followed. Major cardiac events (MACE), including cardiac death, nonfatal myocardial infarction (MI), and TVR occurring , 1 year or , 1 year were assessed 5.2 (4.4-5.6) years after the index procedure. RESULTS: During the entire follow-up period, the total MACE rate was 49.4%. Within the first year and at , 1 year, MACE rates were 25.9% and 23.5%, cardiac death occurred in 2.4% and 6.2%, and nonfatal MI in 6.2% and 12.3% for annual cardiac death/MI rates of 8.7% at 32 mm ...
Results from the PRISON IV Trial Presented at TCT 2016 and Simultaneously Published in JACC: Cardiovascular Interventions. WASHINGTON - November 2, 2016 - Results from a randomized, multicenter trial failed to show non-inferiority of hybrid, ultra-thin strut sirolimus-eluting stents (Osiro SES) with a biodegradable polymer compared to thin-strut everolimus-eluting stents (Xience EES) with a durable polymer in terms of in-segment late lumen loss in successfully treated chronic total occlusions. In addition, although the rate of binary restenosis was low overall in this complex lesion subset, it was higher with the Osirio SES compared with the Xience EES.. Findings from the PRISON IV trial were reported today at the 28th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the worlds premier educational meeting specializing in interventional cardiovascular medicine. The study was also published in the ...
Drug-coated/drug-eluting balloons (DCB/DEB) have been shown to be very effective in treatment of patients with DES-ISR [4]. According to a single-center, randomized study, DCB showed better clinical and angiographic results in treatment of DES-ISR in comparison to BA [9]. The PEPCAD-DES study, a prospective, multicenter, randomized trial of 110 randomly assigned patients, comparing the impact of paclitaxel-coated balloon angioplasty for treatment of DES-ISR versus conventional BA showed that paclitaxel-coated balloon angioplasty was superior to BA alone for treatment of DES-ISR [10]. In addition, ISAR-DESIRE 3 study, a prospective, randomized, multicenter clinical trial including 402 patients with "limus"-DES-ISR comparatively investigated the efficacy of paclitaxel-eluting balloon versus paclitaxel-eluting stent versus BA alone and confirmed that DCB/DEB was non-inferior to PES and that both DCB/DEB and PES were superior to BA alone in treatment of DES-ISR [11]. Available data from these ...
Use of drug-eluting stents is associated with a lower risk of major cardiovascular events at one year compared to bare metal stents when followed by an individualized course of blood-thinning medication among patients previously thought to be uncertain candidates for drug-eluting stents due to their heightened risk of bleeding or blood clots, according to research presented at the American College of Cardiologys 63rd Annual Scientific Session.
TechNavios analysts forecast the Drug-eluting Stent market in Europe to grow at a CAGR of 4.3 percent over the period 2011-2015. One of the key factors contributing to this market growth is the high prevalence of cardiovascular diseases in the region. The Drug-eluting Stent market in Europe has also been witnessing the trend of formation of strategic alliances among vendors. However, the decline in the average price of drug-eluting stent could pose a challenge to the growth of this market.. TechNavios report, the Drug-eluting Stent Market in Europe 2011-2015, has been prepared based on an in-depth analysis of the market with inputs from industry experts. The report focuses on Europe; it also covers the market landscape and its growth prospects in the coming years. The report also includes a discussion of the key vendors operating in this market.. Key vendors dominating this market space include Boston Scientific Corp., Abbott Vascular, Medtronic Inc., and Cordis Corp.. ...
TCT 2013 presentation of data planned -. DURHAM, N.C., September 30, 2013 - Micell Technologies, Inc. today announced that a peer reviewed article discussing imaging and clinical results of the DESSOLVE I trial of its MiStent Sirolimus Eluting Absorbable Polymer Coronary Stent System (MiStent SES®) was accepted for publication on the JACC Cardiovascular Interventions website. The paper, "First-in-Human Evaluation of a Bioabsorbable Polymer-Coated Sirolimus- Eluting Stent: Imaging and Clinical Results of the DESSOLVE I Trial (DES With Sirolimus and a Bioabsorbable Polymer for the Treatment of Patients With De Novo Lesion in the Native Coronary Arteries)", is planned to also appear in the October 2013 issue of JACC Cardiovascular Interventions.. The article concluded that, upon 18 months follow-up, the MiStent SES - an absorbable polymer-coated, cobalt chromium, sirolimus-eluting stent - was associated with a low and stable in-stent late lumen loss, complete strut coverage, and no stent ...
Stents have been used for over a decade to treat coronary arteries affected by stenosis, a state in which the arteries are narrowed by the deposition of plaque. However, studies have shown that a few years after placement of a stent, restenosis can occur at the site, hindering its purpose. Drug-eluting stents (DES) have a significant impact in treating in-stent restenosis. DES are embedded with drugs like Sirolimus that are released over time once the stent is placed within the artery, reducing the chance of plaque deposition around the stent. But DES increases the risk of thrombosis, formation of blood clots around the stent due to a change in the blood flow profile. To improve the DES characteristics, femtosecond pulsed lasers are used to create nano-textures on the metallic stents. Nano-textures increase the availability of the drug, increase adhesion of the drug and the stent, and minimize requirement of a polymer carrier. If the nano-textured materials can show effective fluid retention ...
Drug-eluting stents are accepted as mainstream endovascular therapy, yet concerns for their safety may be under-appreciated. While failure from restenosis has dropped to below 5%, the risk of stent thrombosis and associated mortality remain relatively high. Further optimization of drug release is required to minimize thrombosis risk while maintaining therapeutic dose.. The complex three-dimensional geometry of deployed stents together with the combination of diffusive and advective drug transport render an intuitive understanding of the situation exceedingly difficult. In situations such as this, computational modeling has proven essential, helping define the limits of efficacy, determine the mode and mechanism of drug release, and identify alternatives to avoid toxicity.. A particularly challenging conformation is encountered in coronary arteries with overlapping stents. To study hemodynamics and drug deposition in such vessels we combined high-resolution, multi-scale ex vivo computed ...
This non-inferiority trial is investigating the efficacy of sirolimus-eluting stent compared with everolimus-eluting stent for the treatment of coronary artery
Drug and Polymer are Designed to be Eliminated within 90 days with Optimized Dissolution Kinetics. DURHAM, N.C., November 29, 2010- Micell Technologies,TM Inc. today announced it has enrolled at Mercy Hospital in Auckland, New Zealand, the first patient in DESSOLVE I (DES with Sirolimus and a bioabsorbable pOLymer for the treatment of patients with de noVo lEsions in the native coronary arteries), a first-in-human clinical trial of the companys investigational MiStentTM Drug Eluting Coronary Stent System (MiStent DES).. DESSOLVE I is a prospective, open-label, non-randomized, single-arm study that is expected to enroll 30 patients at five clinical sites in Belgium, Australia and New Zealand. Candidates for the trial are patients with documented stable or unstable angina pectoris or ischemia. The primary endpoint is in-stent late lumen loss, as measured with angiography in treated de novo lesions ranging in diameter from 2.5 to 3.5 mm and amenable to treatment with a maximum 23 mm long ...
no one suspected the results from the new study, said Morton Kern, a professor of medicine at UC Irvine. "It is one other potential downside to drug-eluting stents," Kern said. The study likely will focus more attention on the process of collateral blood-vessel formation as well as developing new generations of drug-coated stents that dont hinder that process, he said. When drug-coated stents became popular in 2003, they were heralded as a major breakthrough in treating heart disease. The tiny, expandable mesh-like tubes were shown to be far superior to bare-metal stents in preventing the gradual reblockage of arteries, a troubling but seldom fatal process known as restenosis. Drug-coated stents are covered by medicine that slowly dissolves and that can dramatically reduce the formation of scar tissue that can re-block an artery. About 1 million Americans are implanted with stents each year and an estimated 80 percent of those devices are drug-coated. However, in recent months researchers and ...
It was reported that stent explantation occurred. The target lesion was located in the severely calcified left anterior descending (lad) artery. Following pre-dilatation, a 4. 00 x 20 synergy drug-eluting stent was implanted in the mid lad, followed by the implantation of a 4. 00 x 28 synergy drug-eluting stent in the proximal lad. However, it was noted that the proximal lad stent was malapposed and the two stents became stuck. During removal of the proximal lad stent, it got caught in the mid lad stent and both stents were removed from the patient. The procedure was completed with another of the same device. No patient complications were reported and the patients status was stable. ...
Drug-Eluting Stents Can Cause Serious Consequences. Drug-eluting stents have greatly reduced the risk of repeat blockage of heart disease.
To find out the predictive value of the ΣΔST/ΔHR index for restenosis after percutaneous coronary intervention (PCI). Subjects of this research were patients who participated in a cardiac rehabilitation (CR) program as six to eight weeks of
This head-to-head trial will assess the non-inferiority of NEVO sirolimus-eluting stent to the XIENCE V everolimus-eluting stent for the prevention of coronary
Additionally, no patient in the calcified group suffered from stent thrombosis up to 3 years after PCI, while two thrombotic complications occurred in the noncalcified group. Although large population studies with long-term follow-up are mandatory, the authors concluded that EES implantation for calcified culprit lesions appears to be safe up to 3 years. This study also demonstrated that the rates of in-stent ABR (4.3%) and ID-TLR (5.9%) at 6 months for calcified culprit lesions are remarkably lower than that in previous BMS studies, in which these rates ranged from 12 to 23% and from 18 to 23%, respectively, suggesting that EES implantation is more effective for calcified culprit lesions than BMS implantation ...
CLEVELAND -- A pair of studies reported today provide additional evidence that drug-eluting stents have eclipsed bare-metal stents in both efficacy and long-term safety.
Are you a healthcare professional? See why the Integrity Bare Metal Stent from Medtronic may be an ideal coronary stent solution for your patients.
An overview of drug-eluting stents (a.k.a drug coated stents or medicated stents or DES) which explains the basics about these devices, including key vocabulary, optimal placement with FFR and IVUS
294456589 - EP 0974313 A1 2000-01-26 - Stent implantation catheter assembly - [origin: DE19833215C1] Catheter arrangement (1) for stent implantation, comprises a guide unit (2,3), a collapsable and expandable balloon (4) fixed to the guide unit, a stent (5) which can be placed on the balloon outer wall (6), and at least two X-ray markers. A fixing unit for the stent is located in the balloon.[origin: DE19833215C1] Catheter arrangement (1) for stent implantation, comprises a guide unit (2,3), a collapsable and expandable balloon (4) fixed to the guide unit, a stent (5) which can be placed on the balloon outer wall (6), and at least two X-ray markers. A fixing unit for the stent is located in the balloon.
The medium-term follow-up data from the ABSORB trial were published in the recent issue of the Lancet. (3) At 2 years after implantation the BVS stent was completely bioabsorbed with restoration of vasomotion and no need for ischaemia-driven repeat revascularisation. In the 29 out of the 30 patients for whom follow-up data were available, the clinical outcomes at 2 years included only 1 (3.6%) non Q-wave myocardial infarction but no cardiac deaths or ischaemia-driven target lesion revascularisation (TLR). In addition there were no instances of stent thrombosis. At 18 months, multislice CT confirmed a mean diameter stenosis of 19 ± 9%. At 2 year coronary angiography, the in-stent late loss and diameter stenosis were shown to be 0.48 mm (SD 0.28) and 27% respectively. These did not differ from the findings at 6 months. At OCT, 34.5% of the stent strut locations presented no discernable features confirming decreases in echogenicity and radiofrequency backscattering, with the remaining apparent ...
Objective To evaluate the effect of integrative medical therapy on lower limb post-angioplasty arterial restenosis in diabetes patients. Methods Thirty-six patients with lower limb diabetic arterial disease of Fontaine Ⅲ/Ⅳ stage after successful baloon angioplasty were assigned randomly and equally to two groups,the control group and the treatment group,both were treated with basic therapy for 3 months,but Chinese drugs were given to the treatment group additionally. Level of acroesthesia was determined before and after treatment with simplified McGill pain questionnaire (SF-MPQ) scoring,ankle brachial index (ABI),toe brachial index (TBI),mean flow velocity of dorsal artery (MDA) and tibial artery (MTA) were measured by ultrasound Doppler meter,and blood preparation was determined. Moreover,the ulcer remission rate,ulcer cure rate,restenosis rate,and amputation rate were determined in the 6-month and 12-month follow-up studies. Results Significant improvements of ABI,TBI,MDA and MTA,as well as on
Unknown author (‎2003)‎. Drug-eluting stent for clogged heart arteries. WHO drug information 2003 ; 17(‎2)‎ : 108-109 https://apps.who.int/iris/handle/10665/72142 ...
Learn about the unprecedented clinical outcomes of Boston Scientific’s groundbreaking drug-eluting technology, including the Eluvia Drug-Eluting Stent.
The SDS418 Self-expanding Peripheral Stent has an open cell peak-to-valley design and comes in different characteristics and 4 F indroducer compatible. Thin stent struts for lower restenosis rate. Two tantalium marker at each stent end for propper visibility. Stent diameter from 4 to 7 mm and a length from 30 to 200 mm. Marker band on outer shaft and a radiopaque tip for absolutely controlled stent deployment. Long lesion treatment with a single stent. Multifunctional braided catheter for optimal balance between pushability, trackability and accurate stent placement.. ...
A method for preventing a restenosis within a vessel wall requires a medicament be delivered at predetermined locations into the vessel wall and allowed to subsequently disperse in a predetermined pattern. To deliver the medicament, a catheter with an expanding member is advanced into the vasculature of a patient until the expanding member is located as desired. The expanding member is then expanded to force dispensers into the vessel wall to the proper depth. A medicament is then pumped through the dispensers to create a plurality of equally spaced, localized medicinal deliveries which subsequently disperse to medicate an annulus shaped volume within the vessel wall.
Has your heart thrown up a red flag? When our hearts are ailing, it affects all areas of our health. So whether youve been diagnosed with a serious heart condition or have had a minor cardiovascular scare, theres no greater priority than taking care of your bodys most critical muscle. Thats exactly what the specialists at INTEGRIS Heart Hospital do - help your heart be the healthiest it can be. Hear from some of our physicians below, plus meet some of our patients and share in their journey. If you have questions or need assistance, call 405-949-3011. ...
An intravascular stent having a prefabricated, patterned polymeric sleeve for controlled release of therapeutic drugs and for delivery of the therapeutic drugs in localized drug therapy in a blood vessel is disclosed. The polymeric sleeve is attached to at least a portion of an outside surface area of the stent structure. Alternatively, a plurality of individual microfilament strands are longitudinally attached to an outer surface of a stent structure in a spaced apart orientation and loaded with at least one therapeutic drug for the release thereof at a treatment site. The stent has a high degree of flexibility in the longitudinal direction, yet has adequate vessel wall coverage and radial strength sufficient to hold open an artery or other body lumen. Methods for making the same are also disclosed.
The FDA has approved Promus Element Plus, a platinum-chromium coronary stent that elutes everolimus, manufacturer Boston Scientific announced.
Washington, D.C. Drug-coated stents that prop open the arteries of about 3 million people in the U.S. dont increase the risk of heart attack or death when used as labeled but may put patients at risk for blood clots, health advisers said Thursday.. While the panel of experts broadly dismissed the more serious risks, they split on characterizing the degree of the increased clotting risk in comparison with older, bare-metal stents. They agreed only that more study of the newer devices is needed.. The panel also said any safety concerns fail to outweigh the benefits of the stents - tiny mesh tubes used like scaffolding to keep blood free-flowing through the arteries. Drugs that coat the stents elute, or dissolve, into the bloodstream to prevent reclogging of arteries.. The mixed verdict came at the outset of a two-day meeting of the Food and Drug Administration advisers, convened to discuss possible clotting and associated risks of the drug-coated stents. The panels findings Thursday apply only ...
A stent for delivering therapeutic agents to a body lumen includes a plurality of circumferential serpentine bands with each band comprising a plurality of struts. At least one strut has at least one first well region and at least one second well region. The at least one first well region has a first thickness, the at least one second well region has a second thickness, the first thickness being greater than the second thickness. Each well region defines a well having a depth. At least some of the wells contain a therapeutic agent.
A stent and a method of making it from a wire, which method includes winding the wire on a mandrel, heating to form a coiled spring, and reversing the winding direction of the coiled spring to form the reversed coiled spring stent. The stent so formed may be reheated over a special mandrel so as to partly relax the outer portion of some or all of the stent coils. The stent may be made up of two or more sections, with adjoining section wound in opposite senses. Such a stent may be deployed by winding the stent onto a catheter, immobilizing the two ends of the wire and one or more intermediate points, bringing the stent to the location where it is to be deployed, and releasing first the intermediate point or points and then the end points. The release of the wire may be accomplished by heating the thread immobilizing the wire so that the thread breaks and releases the wire.
Stents which are inserted into a body lumen preferably are made of materials which are not radiopaque enough, such as stainless steel 316L. X-ray visualization of a stent enables an accurate positioning of the stent and also a follow-up of its functioning within the patients body. The radiopaque markers described here are rivets made of a material which is more radiopaque than the stent substance so the location of the stent can be identified. Preferably the stents are heat treated so that atoms from the stent material migrate into the marker material and vice versa.
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J&J said it was pulling its Co-Star drug-eluting stent from overseas markets and withdrawing its U.S. application following poor results in a clinical trial.
Although drug-eluting stents dramatically reduce stent restenosis, in-stent restenosis still occurs in approximately 10% of sirolimus-eluting stent (SES) implantation cases. Optical coherence tomography (OCT) has the potential to assess neointima hyperplasia precisely in vivo (1). However, the morphological features of stent fracture in OCT imaging have not yet been reported, and there is no OCT study that clarifies the relationship between stent fracture and neointimal hyperplasia in SES. We investigated the morphological features of stent fracture in OCT to clarify the relationship between stent fracture and neointimal hyperplasia in SES.. We enrolled 110 adequately expanded SES (BxVelocity platform) stents from 70 patients. For overlapped stents (n = 41), we confirmed complete overlapping in the post-procedural angiography. The scheduled coronary angiography and OCT imaging were performed at 11 ± 6 months after SES implantation. According to the presence of stent fracture in breath-hold ...
TY - JOUR. T1 - ComparisOn of neointimal coVerage between zotaRolimus-eluting stent and everolimus-eluting stent using Optical Coherence Tomography (COVER OCT). AU - Kim, Jung Sun. AU - Kim, Byeong Kuk. AU - Jang, Ik Kyung. AU - Shin, Dong Ho. AU - Ko, Young Guk. AU - Choi, Donghoon. AU - Hong, Myeongki. AU - Cho, Yun Kyeong. AU - Nam, Chang Wook. AU - Hur, Seung Ho. AU - Choi, Jin Ho. AU - Song, Young Bin. AU - Hahn, Joo Yong. AU - Choi, Seung Hyuk. AU - Gwon, Hyeon Cheol. AU - Jang, Yangsoo. PY - 2012/4/1. Y1 - 2012/4/1. N2 - Background: Data on strut surface coverage of second-generation drug-eluting stents (DES) are limited. We investigated stent strut coverage of resolute zotarolimus-eluting stent (ZES-R) or everolimus-eluting stent (EES) at 9 months after implantation using optical coherence tomography (OCT). Methods: ComparisOn of neointimal coVerage betwEen zotaRolimus-eluting stent and everolimus-eluting stent using Optical Coherence Tomography (COVER OCT) is a prospective, randomized, ...
OBJECTIVES: We used optical coherence tomography, which has a resolution of |20 microm, to analyze thin layers of neointima in rapamycin-eluting coronary stents. BACKGROUND: Lack of neointimal coverage has been implicated in the pathogenesis of drug-eluting coronary stent thrombosis. Angiography and intracoronary ultrasound lack the resolution to examine this. METHODS: We conducted a randomized trial in patients receiving polymer-coated rapamycin-eluting stents (Cypher, Cordis, Johnson & Johnson, Miami, Florida) and nonpolymer rapamycin-eluting stents (Yukon, Translumina, Hechingen, Germany) to examine neointimal thickness, stent strut coverage, and protrusion at 90 days. Twenty-four patients (n = 12 for each group) underwent stent deployment and invasive follow-up at 90 days with optical coherence tomography. The primary end point was binary stent strut coverage. Coprimary end points were neointimal thickness and stent strut luminal protrusion. RESULTS: No patient had angiographic restenosis. For
Stent thrombosis (ST) is an acute thrombotic occlusion in the stented segment of a coronary artery. It is a serious complication that frequently presents as an acute myocardial infarction and/or sudden death. The most recently accepted definition established by the Academic Research Consortium classifies ST as: early (occurring within 30 days), late (30 days to 1 year) or very late (after 1 year). Very late ST has been reported following drug-eluting stent implantation with rates up to 0.6% per year. However, very late ST is unusual after bare-metal stent (BMS) implantation. Here we report a case of patient presenting with ST-elevation myocardial infarction due to very late ST occurring 2 years after BMS implantation. Keywords: Stent thrombosis, Percutaneous coronary intervention, Bare metal stent, Drug eluting stent
Since the drug eluting stents have provided better results concerning restenosis and repeat revascularization comparing to bare metal stents, percutaneous coronary interventions are performing increasingly in more complex stenoses. However, drug eluting stents did not show any advantage on prevention of myocardial infarction and survival. Currently there is no any completed controlled randomized study showing the superiority or equality of drug eluting stents over coronary bypass surgery by means of efficacy and safety. While the long-term results of drug eluting stents still unclear, everyday progressively more patients with multivessel disease are undergoing percutaneous coronary intervention with drug eluting stent implantation. The aim of this review is to discuss the efficacy and safety of drug eluting stents in patients with multivessel disease.. Keywords: Coronary artery disease, stent, drug-eluting stent, multivessel disease, coronary bypass ...
A coronary stent is a tubular structured device made of a thin mesh of wire, which may also be coated with a polymer containing a drug, or made of biodegradable materials. Coronary stents are utilized during percutaneous coronary interventions (PCIs) for the treatment of patients suffering from various coronary artery diseases (CADs) such as acute myocardial infarction, angina pectoris and others. At present, several researches are being conducted in the field of coronary stenting, in order to minimize side effects such as restenosis and thrombosis. Certain new and advanced coronary stents such as bio-absorbable stents have been commercialized in the global market, which demonstrate very less or no common side effects of coronary stenting.. Request a Sample Copy of the Report @ http://www.mrrse.com/sample/1170. The market for coronary stents can be broadly classified into three major segments, namely, bare metal stents (BMS), drug eluting stents (DES) and bio-absorbable stents. In 2011, the drug ...
Objective: To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents. Design: Prospective, observational single centre study. Setting: A single tertiary referral centre. Patients: Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure. Interventions: MSCT and IVUS imaging at 9-12 months follow-up were performed for all patients. Main outcome measures: Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm2 by IVUS. Results: 52 patients were analysed. Passing-Bablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was ...

1993 - Atherectomy led to a greater gain in lumen size than did balloon angioplasty
         but restenosis rates and clinical...1993 - Atherectomy led to a greater gain in lumen size than did balloon angioplasty but restenosis rates and clinical...

They were developed because of the persistent unacceptably high restenosis rate (30% to 50%) associated with PTCA. The Coronary ... A comparison of directional atherectomy with coronary angioplasty in patients with coronary artery disease. N Engl J Med. 1993 ... The coronary atherectomy catheter (Simpson Coronary Atherocath) has subsequently been modified, guiding catheter technology has ... Inclusion criteria were angiography-proven diseased native coronary vessels with no previous coronary interventions, stenosis ...
more infohttp://www.acpjc.org/Content/120/1/issue/ACPJC-1994-120-1-004.htm

WikiGenes - Coronary RestenosisWikiGenes - Coronary Restenosis

Disease relevance of Coronary Restenosis. *Potential role of human cytomegalovirus and p53 interaction in coronary restenosis [ ... High impact information on Coronary Restenosis. *Decreased rate of coronary restenosis after lowering of plasma homocysteine ... Chemical compound and disease context of Coronary Restenosis. *In contrast, late coronary restenosis developed in only 7 (11%) ... Costs of coronary restenosis (Lovastatin Restenosis Trial). Gilbert, S.P., Weintraub, W.S., Talley, J.D., Boccuzzi, S.J. Am. J ...
more infohttps://www.wikigenes.org/e/mesh/e/19956.html

Impact of Cilostazol on Restenosis After Percutaneous Coronary Balloon Angioplasty | CirculationImpact of Cilostazol on Restenosis After Percutaneous Coronary Balloon Angioplasty | Circulation

Restenosis after successful coronary angioplasty: pathophysiology and prevention. N Engl J Med. 1988;318:1734-1737. ... Restenosis after coronary angioplasty: potential biologic determinants and role of intimal hyperplasia. Circulation. 1989;79: ... Impact of Cilostazol on Restenosis After Percutaneous Coronary Balloon Angioplasty. Etsuo Tsuchikane, Atsunori Fukuhara, Tohru ... Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon: a quantitative angiographic study in ...
more infohttp://circ.ahajournals.org/content/100/1/21

Beyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials | CirculationBeyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials | Circulation

Beyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials. Donald E. Cutlip, Amit G. Chhabra ... Beyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials ... Beyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials ... Beyond Restenosis. Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trials ...
more infohttp://circ.ahajournals.org/content/early/2004/08/30/01.CIR.0000140721.27004.4B

Employing Drug-Eluting Stents Differ Broadly, Moderately Correlated With Coronary Artery Restenosis RiskEmploying Drug-Eluting Stents Differ Broadly, Moderately Correlated With Coronary Artery Restenosis Risk

Study of many percutaneous coronary intervention procedures imply that employing drug-eluting stents differ among U.S. ... Drug-Eluting Stents Do Not Affect Risk of Restenosis of Coronary Artery in Angioplasty Patients. The risk of restenosis ( ... Also it is only modestly correlated with the patients risk of coronary artery restenosis (renarrowing), states a report ... Employing Drug-Eluting Stents Differ Broadly, Moderately Correlated With Coronary Artery Restenosis Risk. ...
more infohttp://www.medindia.net/news/employing-drug-eluting-stents-differ-broadly-moderately-correlated-with-coronary-artery-restenosis-risk-103945-1.htm

Dual-source coronary computed tomography angiography for detecting in-stent restenosis | HeartDual-source coronary computed tomography angiography for detecting in-stent restenosis | Heart

Objective To evaluate the performance of Dual source CT coronary angiography (DSCT-CA) in the detection of in-stent restenosis ... Setting Many patients undergo coronary artery stenting; availability of a non-invasive modality to detect in-stent restenosis ... Conclusion DSCT-CA performs well in the detection of in-stent restenosis. Although DSCT-CA leads to frequent false positive ... Design / Patients We prospectively evaluated 100 patients (78 males, age 62 ± 10) with chest pain after coronary stenting. DSCT ...
more infohttp://heart.bmj.com/content/early/2007/09/19/hrt.2007.126474

The Predictive Value of ΣΔST/ΔHR Index for Restenosis after Percutaneous Coronary Intervention.The Predictive Value of ΣΔST/ΔHR Index for Restenosis after Percutaneous Coronary Intervention.

To find out the predictive value of the ΣΔST/ΔHR index for restenosis after percutaneous coronary intervention (PCI). Subjects ... At 6-9 months, angiographic restenosis was measured as an in-segment late loss of the stented coronary artery in addition to ... Schroeder E,Marchandise B,de Coster P,Brichant C,Mitri K,Pieters D,Kremer R. Detection of restenosis after coronary angioplasty ... OBJECTIVE: To find out the predictive value of the ΣΔST/ΔHR index for restenosis after percutaneous coronary intervention (PCI ...
more infohttp://www.biomedsearch.com/nih/Predictive-Value-Index-Restenosis-after/22977781.html

SEDUCE OCT Study in Coronary Artery rEstenosis:an Optical Coherence Tomography (OCT) StudySEDUCE OCT Study in Coronary Artery rEstenosis:an Optical Coherence Tomography (OCT) Study

... clinicaltrials.gov Different healing responses after treatment of bare metal stent restenosis with implantation of an ... Home » Topics » Stent » Research » SEDUCE OCT Study in Coronary Artery rEstenosis:an Optical Coherence Tomography (OCT) Study ... More From BioPortfolio on "SEDUCE OCT Study in Coronary Artery rEstenosis:an Optical Coherence Tomography (OCT) Study". * ... SEDUCE OCT Study in Coronary Artery rEstenosis:an Optical Coherence Tomography (OCT) Study. 2014-08-27 03:16:02 , BioPortfolio ...
more infohttps://www.bioportfolio.com/resources/trial/68075/SEDUCE-OCT-Study-in-Coronary-Artery-rEstenosis-an-Optical-Coherence-Tomography-OCT.html

Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24...Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24...

Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 ... Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 ... Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 ... Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 ...
more infohttp://www.bmj.com/content/351/bmj.h6364

Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes |...Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes |...

OBJECTIVE-Despite the popularity of coronary stenting in coronary artery disease (CAD), restenosis remains a challenging ... Carrozza JP Jr, Kuntz RE, Fishman RF, Baim DS: Restenosis after arterial injury caused by coronary stenting in patients with ... This study demonstrated that rosiglitazone significantly reduced restenosis rate in the 6 months after coronary stenting in the ... Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes. ...
more infohttp://care.diabetesjournals.org/content/27/11/2654

PIoglitazone for PrEvention of Restenosis in Diabetic Patients | Clinical Research Trial Listing ( Diabetes |  Coronary...PIoglitazone for PrEvention of Restenosis in Diabetic Patients | Clinical Research Trial Listing ( Diabetes | Coronary...

Coronary Atherosclerosis , PIoglitazone for PrEvention of Restenosis in Diabetic Patients ... restenosis after successful implantation of a sirolimus-eluting coronary stent for treatment of de-novo "complex" coronary ... Restenosis requiring reintervention is still a limitation of percutaneous coronary angioplasty. Despite the use of Drug eluting ... Quantitative Coronary Angiography Baseline, postprocedural, and follow-up coronary angiograms will be digitally recorded and ...
more infohttp://www.centerwatch.com/clinical-trials/listings/33601/coronary-atherosclerosis-pioglitazone-prevention-restenosis-diabetic/?&radius=50

Proximal coronary artery intervention : Stent thrombosis, restenosis and deathProximal coronary artery intervention : Stent thrombosis, restenosis and death

Proximal coronary artery intervention: Stent thrombosis, restenosis and death. Calais, Fredrik Lagerqvist, Bo Uppsala ... Conclusions: Following proximal coronary artery intervention restenosis was more frequent in the LAD than in the LCX. Solely in ... No differences in restenosis or ST were seen between the LAD and the RCA. The frequency of restenosis and ST was higher in the ... Background: Percutaneous coronary intervention (PCI) of lesions in the proximal left anterior descending coronary artery (LAD) ...
more infohttp://uu.diva-portal.org/smash/record.jsf?faces-redirect=true&language=no&searchType=SIMPLE&query=&af=%5B%5D&aq=%5B%5B%5D%5D&aq2=%5B%5B%5D%5D&aqe=%5B%5D&pid=diva2%3A689125&noOfRows=50&sortOrder=author_sort_asc&sortOrder2=title_sort_asc&onlyFullText=false&sf=all

Clinical research Plasma asymmetric dimethylarginine predicts restenosis after coronary angioplasty
	Clinical research Plasma asymmetric dimethylarginine predicts restenosis after coronary angioplasty

Asymmetric dimethylarginine may influence the process of restenosis after coronary angioplasty. The aim of the study was to ... Endothelial dysfunction and restenosis following percutaneous coronary intervention. Int J Cardiol 2007; 119: 362-7. 25. Suda O ... The aim of the study was to determine if initial plasma ADMA level could predict restenosis after coronary angioplasty and ... The role of biochemical factors in the pathogenesis of coronary artery restenosis after PCI continues to be the subject of ...
more infohttps://www.termedia.pl/Clinical-research-Plasma-asymmetric-dimethylarginine-predicts-restenosis-after-coronary-angioplasty,19,17060,1,1.html

Clinical Results and Restenosis Analysis of Symptomatic Ostial Vertebral Artery Stenosis Treated With Tubular Coronary Stents -...Clinical Results and Restenosis Analysis of Symptomatic Ostial Vertebral Artery Stenosis Treated With Tubular Coronary Stents -...

Clinical Results and Restenosis Analysis of Symptomatic Ostial Vertebral Artery Stenosis Treated With Tubular Coronary Stents. ... Clinical Results and Restenosis Analysis of Symptomatic Ostial Vertebral Artery Stenosis Treated With Tubular Coronary Stents. ... reports a relative high restenosis rate in a longer follow-up duration. Restenosis seems to become an important issue regarding ... and primary stenting have been shown to be safe and effective with lower restenosis rate. Coronary equipments are ideal for ...
more infohttps://clinicaltrials.gov/ct2/show/NCT00172458

Effects of Celecoxib On Restenosis After Coronary Intervention and Evolution of Atherosclerosis Trial | Clinical Research Trial...Effects of Celecoxib On Restenosis After Coronary Intervention and Evolution of Atherosclerosis Trial | Clinical Research Trial...

Percutaneous Coronary , Angioplasty , Effects of Celecoxib On Restenosis After Coronary Intervention and Evolution of ... Restenosis is the major adverse effect of coronary stent implantation. Drug-eluting stent has markedly reduced restenosis as ... Effects of Celecoxib On Restenosis After Coronary Intervention and Evolution of Atherosclerosis Trial ... the main cause of repeat coronary intervention after drug-eluting stent implantation. After coronary stent implantation, ...
more infohttp://www.centerwatch.com/clinical-trials/listings/38221/angioplasty-transluminal-percutaneous-coronary-effects-celecoxib-on-restenosis/?&radius=50

PROVIDENCE:Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With Coronary Lesions - Full Text...PROVIDENCE:Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With Coronary Lesions - Full Text...

PROVIDENCE:Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With Coronary Lesions. The ... PROVIDENCE: Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With de Novo Coronary Lesions. ... Coronary Artery Disease Diabetes Mellitus Procedure: Percutaneous Coronary Intervention (PCI) Phase 2 Phase 3 ... Target lesion is due to restenosis. *3 vessel coronary artery disease defined as ≥70% ischemia producing lesions in 3 different ...
more infohttps://clinicaltrials.gov/ct2/show/study/NCT00116792?view=results

Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography | HeartIncidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography | Heart

Objective Systematic investigation of restenosis after percutaneous coronary intervention (PCI) with bare metal stents (BMS) or ... Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography ... Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography ... Binary restenosis was detected in 2643 (26.4%) patients. Use of first generation DES versus BMS (OR 0.35, 95% CI 0.31 to 0.39) ...
more infohttp://heart.bmj.com/content/100/2/153

Aggressive Post-Dilation of Coronary Stents and Restenosis | JACC: Cardiovascular InterventionsAggressive Post-Dilation of Coronary Stents and Restenosis | JACC: Cardiovascular Interventions

2014) in Coronary artery restenosis, Stent sizing without intravascular imaging: impact on restenosis, ed Lofti A. (Nova ... Aggressive Post-Dilation of Coronary Stents and Restenosis Message Subject (Your Name) has forwarded a page to you from JACC: ... 1) that described the incidence of the risk factors for stent fracture and restenosis. They highlight an under-recognized ... 2014) Overaggressive stent expansion without intravascular imaging: impact on restenosis. Heart Asia 6:32-35. ...
more infohttp://interventions.onlinejacc.org/content/9/19/2072

Usefulness of early dobutamine stress echocardiography for the assessment of risk of restenosis after percutaneous coronary...Usefulness of early dobutamine stress echocardiography for the assessment of risk of restenosis after percutaneous coronary...

... in the treatment of coronary artery disease and relatively high restenosis rate following PCI require the introduction of ... The increasing role of percutaneous coronary interventions (PCI) ... for the assessment of risk of coronary restenosis. METHODS: ... Coronary Angiography. Coronary Restenosis / radiography, ultrasonography*. Coronary Stenosis / therapy*. Echocardiography, ... In a group of 11 patients with restenosis confirmed in the coronary angiography, one-year follow-up DSE was found positive in 9 ...
more infohttp://www.biomedsearch.com/nih/Usefulness-early-dobutamine-stress-echocardiography/17436153.html

Decreased Rate of Coronary Restenosis After Lowering of Plasma Homocysteine Levels - American College of CardiologyDecreased Rate of Coronary Restenosis After Lowering of Plasma Homocysteine Levels - American College of Cardiology

Decreased Rate of Coronary Restenosis After Lowering of Plasma Homocysteine Levels - Decreased Rate of Coronary Restenosis ... Keywords: Acute Coronary Syndrome, Platelet Aggregation Inhibitors, Coronary Restenosis, Lipids, Constriction, Pathologic, ... YOU ARE HERE: Home , Latest in Cardiology , Decreased Rate of Coronary Restenosis After Lowering of Plasma Homocysteine Levels ... Patients with acute coronary syndromes or creatinine >1.8mg/dl were excluded. The specifics of the PTCA, adjunctive treatment ...
more infohttp://www.acc.org/latest-in-cardiology/clinical-trials/2010/02/23/19/01/decreased-rate-of-coronary-restenosis-after-lowering-of-plasma-homocysteine-levels

Restenosis after Arterial Injury Caused by Coronary Stenting in Patients with Diabetes Mellitus | Annals of Internal Medicine |...Restenosis after Arterial Injury Caused by Coronary Stenting in Patients with Diabetes Mellitus | Annals of Internal Medicine |...

... have a higher incidence of restenosis after coronary stenting, and, if so, whether restenosis is attributable to lesion or ... Restenosis after Arterial Injury Caused by Coronary Stenting in Patients with Diabetes Mellitus Joseph P. Carrozza, MD; Richard ... Restenosis after Arterial Injury Caused by Coronary Stenting in Patients with Diabetes Mellitus. Ann Intern Med. 1993;118:344- ... Review: CABG or stents compared with medical therapy in stable coronary artery disease Annals of Internal Medicine; 161 (8): ...
more infohttps://annals.org/aim/article-abstract/706157/restenosis-after-arterial-injury-caused-coronary-stenting-patients-diabetes-mellitus

High Plasma Levels of Osteopontin in Patients With Restenosis After Percutaneous Coronary Intervention | Arteriosclerosis,...High Plasma Levels of Osteopontin in Patients With Restenosis After Percutaneous Coronary Intervention | Arteriosclerosis,...

High Plasma Levels of Osteopontin in Patients With Restenosis After Percutaneous Coronary Intervention. Ryuichi Kato, Yukihiko ... Potential roles of osteopontin and αvβ3 integrin in the development of coronary artery restenosis after angioplasty. Proc Natl ... Pathophysiology of coronary artery restenosis. Rev Cardiovasc Med. 2003; 3: S4-S9. ... CAD was defined as at least one coronary artery having ,50% luminar diameter stenosis. Restenosis was defined as ,50% luminar ...
more infohttp://atvb.ahajournals.org/content/26/1/e1

Angiotensin-converting enzyme insertion/deletion polymorphism does not influence the restenosis rate after coronary stent...Angiotensin-converting enzyme insertion/deletion polymorphism does not influence the restenosis rate after coronary stent...

All patients underwent elective coronary stent implantation in a stenosis of a major coronary vessel. Balloon inflations were ... we therefore tested the relationship between the ACE gene polymorphism and the restenosis rate after coronary stent ... Angiotensin-converting enzyme insertion/deletion polymorphism does not influence the restenosis rate after coronary stent ... In all, 39 patients (25.3%) had significant restenosis: 12 DD patients (25.0%), 18 ID patients (21.7%) and 9 II patients (39.1 ...
more infohttps://epub.ub.uni-muenchen.de/17012/index.html

Abstract 384: Association between Renin Angiotensin System Gene Polymorphisms and Severity of Coronary Artery Disease and...Abstract 384: Association between Renin Angiotensin System Gene Polymorphisms and Severity of Coronary Artery Disease and...

... receptor in relation to severity of coronary artery disease and in-stent restenosis after coronary stenting. ... A subsequent coronary angiography was performed 6-9 months later for suspected restenosis for patients (N=273) who underwent ... Conclusion: Genetic polymorphisms of RAS are not associated with in-stent restenosis after coronary stenting. However, the ... Percutaneous coronary intervention (PCI) is an effective technique for coronary revascularization but a considerable number of ...
more infohttp://atvb.ahajournals.org/content/35/Suppl_1/A384

A correlation found between contact allergy to stent material and restenosis of the coronary arteries.A correlation found between contact allergy to stent material and restenosis of the coronary arteries.

... Svedman, Cecilia LU ; ... The restenosis rate was evaluated. RESULTS: We found a correlation between contact allergy to gold, gold stent, and restenosis ... The restenosis rate was evaluated. RESULTS: We found a correlation between contact allergy to gold, gold stent, and restenosis ... The restenosis rate was evaluated. RESULTS: We found a correlation between contact allergy to gold, gold stent, and restenosis ...
more infohttps://lup.lub.lu.se/search/publication/1368007
  • We designed a prospective, randomized, controlled study to verify the hypothesis that rosiglitazone, another member of the TZD class, reduces the rate of restenosis in type 2 diabetic patients who have undergone coronary stenting. (diabetesjournals.org)
  • Despite the use of Drug eluting stent (DES), the rate of restenosis remains 7% to 16% in diabetic patients, making it a challenging problem in interventional cardiology. (centerwatch.com)
  • Treatment lowered homocysteine levels from 11.1 +/- 4.3μm/L to 7.2 +/- 2.4 μm/L. The rate of restenosis was significantly lower on treatment (19.6% vs 37.6%, p = 0.01) as was the need for target vessel revascularization (10.8% vs. 22.3%, p = 0.047). (acc.org)
  • Treatment with a combination of folic acid, vitamin B-12, and pyridoxine significantly reduces the rate of restenosis following PTCA and the need for target vessel revascularization after PCI. (acc.org)
  • Use of first generation DES versus BMS (OR 0.35, 95% CI 0.31 to 0.39) and second generation DES versus first generation DES (OR 0.67, 95% CI 0.58 to 0.77) were independent predictors of lower rates of restenosis. (bmj.com)
  • Recently a few reports on prevention of restenosis in type 2 diabetic patients (T2DM) with the use of TZDs as been published. (centerwatch.com)
  • This study evaluated the efficacy of rosiglitazone for preventing in-stent restenosis in type 2 diabetic patients. (diabetesjournals.org)
  • VISION(tm) and/or MINI-VISION(tm)) stent and pharmacologic therapy with the oral PPAR-gamma agonist rosiglitazone will significantly reduce restenosis after intracoronary stenting in type 2 diabetic patients. (clinicaltrials.gov)
  • After arterial injury produced by stent placement, diabetic patients have a significantly greater incidence of restenosis because of greater late loss at the treatment site. (annals.org)
  • Because elastic recoil or vasospasm contributes little to stent restenosis, the increased late loss of minimum lumen diameter in diabetic patients suggests that they have a greater predisposition to intimal hyperplasia. (annals.org)
  • Physicians should take measures to control RLP-C below the level of 0.505 mmol/L to better prevent of in-stent restenosis in diabetic patients. (springer.com)
  • Exercise thallium scintigraphy is a useful method for the detection of restenosis. (eur.nl)
  • Patients with a significantly positive stress treadmill with ST depressions more than 4 mm and with a low exercise tolerance (less than about 4 MET) were qualified for coronary angiography. (termedia.pl)
  • This study was a prospective, randomized trial comparing the effect of cilostazol on restenosis with conventional antiplatelet therapy of aspirin. (ahajournals.org)