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Search Results: 1 - 10 of 4219 matches for " Coronary stents "
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Percutaneous Coronary Interventional Treatment for Coronary Artery Disease and the Role of Antiplaplatelets Therapy: A Review of the Literature  [PDF]
Mostafa Al Shamiri, Abdulelah F. Al Mobeirek, Hanan Albackr, Turki B. Albacker
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.55041

Uses of balloon catheters or BMS for the treatment of coronary artery lesions shows good short-term results but long-term follow up revealed restenosis in up to 20%-30% of patients. Thus new improvements to balloons and stents are always necessary to achieve the best results from percutaneous coronary intervention (PCI). Drug-eluting stents (DES) improved the principles of bare metal stents (BMS) by local drug release to inhibit neointimal growth. DES reduced the incidence of in-stent restenosis. These benefits and lower costs compared to surgical treatment make the DES an attractive alternative for the treatment of coronary artery disease. Different components of DES which include the polymers, drugs and the stents underwent progressive evolution, and these led to development of new generations of DES with variable types of drugs and polymers to fully absorbable stents. The concern of stent thrombosis still an issue and dual antiplatlets therapy (DAPT) is mandatory for variable time ranging from one month to one year. This article discusses the main available clinical trials in the developments of BMS, DES and the comparison between both with a prospective look at future technologies in the field, in addition to reviewing the current guideline in the uses of DAPT after PCI.

Are Newer-Generation Drug-Eluting Stents More Effective in Women than Early-Generation Ones?  [PDF]
Andrea Messori, Valeria Fadda, Dario Maratea, Sabrina Trippoli
World Journal of Cardiovascular Diseases (WJCD) , 2014, DOI: 10.4236/wjcd.2014.44021
Abstract: Evidence-based research is increasingly aimed at differentiating between no proof of difference (failed demonstration of superiority) and proof of no difference (demonstration of equivalence). The latter requires that equivalence margins are incorporated in the analysis of outcomes. We applied an analysis of equivalence to study the incremental benefit of newer-generation vs early-generation drug-eluting stents (DES) in women receiving percutaneous coronary intervention. The clinical material was derived from published data. Our equivalence testing was focused on the end-point of target-lesion revascularisation (TLR). Results were expressed as rate differences (RDs), while the equivalence margins (±2.9%) were derived from the statistical power calculations of a recent trial. Our results clearly indicated that, in women, there was an equivalent effectiveness between newer-generation and early-generation of DES.
Reduction in the Corrosion Rate of Magnesium and Magnesium Alloy Specimens and Implications for Plain Fully Bioresorbable Coronary Artery Stents: A Review  [PDF]
Gladius Lewis
World Journal of Engineering and Technology (WJET) , 2016, DOI: 10.4236/wjet.2016.44055
Abstract: The most popular treatment/management modality for coronary artery disease, which is one of the leading causes of death, is percutaneous transluminal coronary intervention (popularly known as “plain old balloon angioplasty”) followed by implantation of a stent (“stenting”). Stent types have evolved from bare metal stents through first-generation drug-eluting stents to fully bioresorbable stents (FBRSs). Two examples of FBRSs are 1) Mg scaffold with no coating; and 2) Mg alloy scaffold coated with a bioresorbable polymer in which an anti-proliferative drug is embedded. In the case of Mg/Mg alloy FBRSs, one of the reported clinical results is that the resorption time of the stent is too short (in vivo resorption time (and, hence, improving the clinical efficacy) of the current generation of fully-bioresorbable Mg/Mg-alloy stents as well as guide the development of the next generation of these stents.
Reestenosis "muy tardía", sintomática, de un stent coronario
Kortsarz,Luis A.; Saravia Toledo,Sebastián; Otero,Oscar A.; Sánchez,Javier A.; Solá,Miguel V.;
Revista argentina de cardiolog?-a , 2007,
Abstract: a 50-year old man presents with symptomatic metallic coronary stent restenosis, eight years and a half after placement. coronary stents present restenosis due to neointimal proliferation followed by late retraction. clinical events related with restenosis generally occur during the first year after placement. the frecuency of "very late" symptomatic restenosis is low. there are few cases reported in literature. "very late" angiographic restenosis is more common. this process is probably due to the development of new in-stent atherosclerotic disease.
Resultados clínicos de pacientes com reestenose intrastent n?o tratada com novo procedimento de revasculariza??o
Gottschall, Carlos Antonio Mascia;Sarmento-Leite, Rogério;Welter, Dulce;Quadros, Alexandre Schaan de;
Revista Brasileira de Cardiologia Invasiva , 2010, DOI: 10.1590/S2179-83972010000400011
Abstract: background: clinical restenosis after coronary stenting is generally treated by target vessel revascularization (tvr). this study was aimed at reporting the clinical profile and outcomes of patients with symptomatic in-stent restenosis (isr) who were not submitted to a tvr. method: patients who presented clinical restenosis after coronary stenting between january 1997 and december 2001 were identified. clinical and angiographic characteristics and clinical outcomes of patients who did not undergo a new revascularization (no-tvr group) were compared with revascularized patients (tvr group). all of the patients had at least 2 years of follow-up for the occurrence of major adverse cardiac events (mace) after stent implantation. results: in the study period, 1,221 stents were implanted in 1,149 patients. isr was observed in 135 patients (12%), of which 104 had complete clinical and angiographic follow-up, 23 in the no-tvr group and 81 in the tvr group. the mean follow-up period after coronary stenting was 30.8 ± 7.5 months. patients in the no-tvr group had a significantly higher percent of one vessel disease (82% vs. 47%; p < 0.01). patients in the no-tvr group had a long-term mace rate of 21.7% (5 patients: 2 deaths, 3 myocardial infarctions), whereas those submitted to a new revascularization showed a subsequent mace rate of 9.8% (8 patients: 1 death, 4 myocardial infarctions, 3 coronary artery bypass graft surgery; p = 0.11). conclusion: patients with clinical isr not treated with a tvr more frequently presented one-vessel disease and a trend towards higher incidence of mace when compared to those treated with a new tvr.
Interven??o coronária percutanea no hospital Vera Cruz de Campinas: resultados de cinco anos de experiência
Gioppato, Silvio;Cantarelli, Marcelo J. C.;Conforti, Thomas Borges;Castello Jr., Helio J.;Gon?alves, Silvio Luiz Pollini;Carvalho, Gustavo Sergio;Spis, Leandro Nista;Calil, David Eduardo;Nicastro, Mauricio T.;Conforti, Pedro A. P.;Baucchi, Antenor;Verri, Vitorio;Verri, Guilherme C.;Louren?o, Mayara Brunheroto;Sampaio, Carlos Eduardo;Lopes, Fabio Rainha;Lopes, Mauricio Marson;Padovani, Ronaldo;Vedovello, Thiago Jair;Otero, Nyder Rodrigues;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000400012
Abstract: background: percutaneous coronary intervention (pci) plays an important role in the treatment of coronary artery disease, as a result of technological development and its wide application in different clinical scenarios of greater complexity. we present data from a cath lab that started its activity five years ago at a private hospital in the city of campinas (sp). methods: from 2006 to 2011, 518 consecutive patients were submitted to pci at the vera cruz hospital and were included in this study. clinical, angiographic and procedural characteristics and the in-hospital clinical outcomes were analyzed. results: patient average age was 65.8 + 12.2 years, 73.5% were male, 29.9% were diabetics and half of procedures were performed during an acute coronary syndrome. a total of 890 lesions (74% b2/c type) were treated with 1.6 stents/patient, 37.1% of them were drug eluting stents. stent diameter and length were 3.01 + 0.53 mm and 23.2 + 7 mm, respectively. the procedure success was 93.6%, death occurred in 2.9% of the patients, stroke in 0.8%, myocardial infarction in 3.5%, reintervention in 0.8% and stent thrombosis in 0.97%. hypertension [odds ratio (or) 4.48, 95% confidence interval (95% ci) 1.32-15.16; p = 0.016] and diabetes (or 7.24, 95% ci 1.69-31.05; p = 0.008) were independent predictors of in-hospital major adverse cardiac and cerebrovascular events (macce). conclusions: the overall procedural success and low incidence of macce demonstrated the efficacy and safety of pci in the daily clinical practice in a new interventional cardiology service, localized in a hospital outside the capital of the state of s?o paulo.
Perfil de risco de reestenose em pacientes submetidos a implante de stents coronarianos convencionais
Quadros, Alexandre Schaan de;Gottschall, Carlos A. M.;Fabiane, Diemer;Diehl, Dayane;Sarmento-Leite, Rogério;Rodrigues, Ana Paula da Rosa;Vizzotto, Mateus D.;Camozzatto, Fernanda;Martins, Jo?o M. P.;Rodrigues Junior, La Hore Corrêa;Sassi, Giana;Modkovski, Thais B.;
Revista Brasileira de Cardiologia Invasiva , 2008, DOI: 10.1590/S2179-83972008000200008
Abstract: background: the restenosis risk of patient populations treated with coronary stent implantation is not well studied. this information has a potential impact on the decision of incorporating a selective strategy of drug-eluting stent implantation by the public health system. our objective was to evaluate the restenosis risk of a population of patients (pts) treated with bare-metal stents. methods: observational study with 4,482 pts treated with 5,336 stents, between january 2000 and december 2007. the restenosis risk was assessed according to a previous validated risk score. points in the score ranged from 0 to 5 according to diabetes mellitus (1 point), reference vessel diameter (< 3 mm = 2 points, 3-3.5 mm = 1, and > 3.5 mm = 0), and the lesion length (> 20 mm = 2 points, 10-20 mm = 1, and < 10 mm = 0). results: the mean age was 60.6 ± 10.6 years of age, and 32% were female. the mean reference vessel diameter was 3.10 mm ± 0.51mm, the lesion length was 13.2 mm ± 5.9 mm, and 20% of the pts were diabetics. the distribution of pts according to points in the risk score was the following: score 0 = 4% of the pts; score 1 = 22%; 2 = 34%; 3 = 29%; 4 = 9%; and score 5 = 1% of the pts. conclusions: the majority of pts presented low or intermediate restenosis risk. the adoption of a selective strategy of drug-eluting stent implantation only in those at higher restenosis risk would represent its use in no more than 20% of the procedures.
Perfil clínico e evolu??o tardia de pacientes com trombose de stent n?o-farmacológico
Silva, Wersley Araújo;Costa Jr, J. Ribamar;Barbosa, Roberto Ramos;Stadler, Jackson;Costa, Ricardo A.;Siqueira, Dimytri A.;Staico, Rodolfo;Feres, Fausto;Chaves, áurea J.;Abizaid, Alexandre;Sousa, Amanda G. M. R.;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2012, DOI: 10.1590/S2179-83972012000400007
Abstract: background: stent thrombosis is the sudden occlusion of a stented coronary artery due to thrombus formation. our objective was to identify variables associated to definite stent thrombosis (st) and assess the outcomes of patients treated with bare-metal stents. methods: consecutive patients treated between december 2007 and august 2012 were analyzed. those with st were compared to those without st as to clinical and angiographic characteristics, and early and late outcomes. results: of a total of 6,495 percutaneous coronary interventions (pcis), 36 cases of st (0.55%) were observed, of which 18 were early (50%), 14 (38.9%) late and 4 (11.1%) very late st. patients with st were younger, with a greater prevalence of chronic renal failure and acute coronary syndromes. st was more frequent in bifurcation lesions (11% vs. 4%; p = 0.03) or lesions with visible thrombus at angiography (55.5% vs. 2.8%; p < 0.01). all patients were submitted to emergency pci, and in the in-hospital phase, myocardial infarction (mi) and death were observed in 33.3% and 16.6%, respectively. mean follow-up was 30.2 ± 16.3 months and early discontinuation of dual antiplatelet therapy was observed in 6 of the 36 cases (16.7%). in the late follow-up target vessel revascularization was observed in 33.3%, mi in 20% and no additional deaths were observed. conclusions: st proved to be an event with high in-hospital mortality and late morbidity. the occurrence of this event was associated to more complex clinical and angiographic characteristics and lower compliance with dual antiplatelet therapy.
Incidência e preditores de revasculariza??o da les?o-alvo no seguimento clínico de longo prazo: análise crítica do Registro DESIRE
Cavalcante, Luciano Pessoa;Sousa, Amanda G. M. R.;Costa, Ricardo A.;Moreira, Adriana;Costa Jr., José Ribamar;Maldonado, Galo;Cano, Manuel;Campos, Cantídio;Carballo, Mariana;Berwanger, Otávio;Jatene, Adib D.;Sousa, J. Eduardo;
Revista Brasileira de Cardiologia Invasiva , 2010, DOI: 10.1590/S2179-83972010000200009
Abstract: background: we report the incidence and predictors of target lesion revascularization (tlr) in a cohort of realworld patients treated with drug eluting stents (des) method: from may 2002 to february 2010, 3,320 patients were treated with elective or emergency percutaneous coronary intervention (pci) and 5,320 des (cypher, 83%; taxus, 9%; xience v/promus, 3%; endeavor, 4%; biomatrix, 1%) were implanted in a single center. the clinical follow-up of up to eight years (median time 3.4 years) was concluded in 98% patients of the group and 129 patients (3.88%) were submitted to tlr results: of the patients with tlr, 33% had diabetes, 10% had chronic kidney disease and 61% had multivessel disease. the left anterior descending artery was the most frequent target vessel (33%) and 72.3% of the lesions were complex lesions (type b2/c). in this group, 214 des were implanted in 191 lesions and 45% of the patients received multiple stents. in the univariate analysis, tlr predictors were: diabetes mellitus [relative risk (rr) 1.88, 95% confidence interval (ci) 1.08-3.27; p = 0.025], use of taxus stents (rr 1.73, 95% ci 1.20-2.50; p = 0.003), ostial lesion (rr 1.82, 95% ci 1.1-2.98; p = 0.018), saphenous bypass graft (rr 2.36, 95% ci 1.55-3.50; p = 0.0001), and restenotic lesions (rr 1.95, 95% ci 1.17-3.24; p = 0.009). after the multivariate analysis, the independent predictors were: diabetes mellitus, use of taxus stents and treatment of lesions in saphenous bypass grafts (rr 1.64, 95% ci, 1.14-2.35; p = 0.008) conclusion: in the desire registry, tlr in complex patients treated with des was low and diabetes mellitus, treatment of lesions in saphenous bypass grafts and the use of taxus stents were the only tlr predictors in the clinical follow-up of up to 8 years.
Tratamento de trombose tardia de stent farmacológico com cateter extrator de trombo
Lacativa, Marcus Ernesto Sampaio;Oliveira, Leonardo Furtado de;Cardoso, Rodrigo de Franco;Frighetto, Jo?o Luiz;Cardoso, Rodolfo de Franco;Campos, Julio Eduardo;Cardoso, Francisco Cabral;Alves, Luiz Paulo Rebello;
Revista Brasileira de Cardiologia Invasiva , 2007, DOI: 10.1590/S2179-83972007000200012
Abstract: we report on the case of a 69-year-old patient with late thrombosis of a drug-eluting stent, admitted to hospital with anterior ami, who was successfully treated using a thrombus extraction catheter (prontotm v3).
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