المؤلفون: Tasal A; Department of Cardiology, Bezmialem Foundation University, Istanbul, Turkey. atasal01@gmail.com, Bacaksiz A, Vatankulu MA, Turfan M, Erdogan E, Sonmez O, Kul S, Ertas G, Sevgili E, Goktekin O

المصدر: Journal of interventional cardiology [J Interv Cardiol] 2013 Aug; Vol. 26 (4), pp. 325-31.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Wiley Country of Publication: United States NLM ID: 8907826 Publication Model: Print Cited Medium: Internet ISSN: 1540-8183 (Electronic) Linking ISSN: 08964327 NLM ISO Abbreviation: J Interv Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Angioplasty, Balloon, Coronary* , Drug-Eluting Stents*/adverse effects, Myocardial Infarction/*therapy, Adult ; Aged ; Coronary Angiography ; Coronary Thrombosis/prevention & control ; Diabetic Angiopathies/therapy ; Dilatation ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

مستخلص: Background: Postdilatation (PD) with noncompliant balloon during elective percutaneous coronary intervention (PCI) is performed usually in clinical practice in order to optimize stent expansion. However, current knowledge about its use in patients undergoing primary PCI is controversial. This study aims to evaluate the angiographical and clinical results of PD in patients who underwent primary PCI with drug eluting stents (DESs).
Methods: A total of 405 consecutive patients (mean age 56.9 ± 12.3 years; 302 male) with ST elevation myocardial infarction were evaluated retrospectively. Patients received DES with or without predilatation according to physician's discretion. Eligible patients were divided into 2 groups based on PD procedure. The clinical end-points were death, target vessel revascularization (TVR) and stent thrombosis at 6 months after PCI. The angiographic end-points were postprocedural correct Thrombolysis in Myocardial Infarction (TIMI) frame count (cTFC), final TIMI flow, and myocardial blush grade (MBG).
Results: PD was performed in 214 patients (52.8%). Angiographical parameters such as TIMI flow, cTFC, and MBG did not differ after PD (P>0.05). During 6-month follow-up, TVR and stent thrombosis rates were lower in the PD group (6 vs. 16, P=0.03; and 3 vs. 10, P=0.04, respectively). PD and diabetes were detected as independent predictors of MACE (β=0.52, P=0.01, and β=-0.47, P=0.02; respectively).
Conclusion: Our study revealed that PD does not yield adverse effects on final angiographic parameters when performed during primary PCI. Besides PD seems to decrease probability of stent thrombosis and TVR.
(© 2013, Wiley Periodicals, Inc.)

المؤلفون: Tanigawa J; Cardiology, 1st Department of Internal Medicine, Osaka Medical College, Osaka, Japan., Sutaria N, Goktekin O, Di Mario C

المصدر: Journal of interventional cardiology [J Interv Cardiol] 2005 Dec; Vol. 18 (6), pp. 455-65.

نوع المنشور: Journal Article; Review

بيانات الدورية: Publisher: Wiley Country of Publication: United States NLM ID: 8907826 Publication Model: Print Cited Medium: Print ISSN: 0896-4327 (Print) Linking ISSN: 08964327 NLM ISO Abbreviation: J Interv Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Blood Vessel Prosthesis Implantation* , Drug Delivery Systems* , Stents*, Coronary Stenosis/*drug therapy, Angioplasty, Balloon, Coronary ; Atherectomy, Coronary ; Coronary Artery Bypass ; Coronary Restenosis/prevention & control ; Coronary Stenosis/physiopathology ; Coronary Stenosis/surgery ; Humans ; Immunosuppressive Agents/administration & dosage ; Sirolimus/administration & dosage

مستخلص: Coronary angiography is often inadequate for estimating the severity of ambiguous left main coronary artery (LMCA) stenoses. Our assessment of these lesions can be improved by the techniques of intravascular ultrasound and fractional flow reserve which provide indices of stenosis severity to enable the prediction of future events and planning of treatment. For patients requiring LMCA revascularization, coronary artery bypass graft (CABG) surgery has been gold standard for decades. However, this technique continues to be limited by factors such as periprocedural mortality, prolonged hospital stay and rehabilitation, and long-term graft patency. LMCA stenosis remains one of the few serious challenges for the interventional cardiologists and, in the bare metal stent era, the long-term results were not sufficient to replace CABG surgery, mainly because of the high restenosis rate. Drug-eluting stents (DES) have dramatically reduced the restenosis rate and early results in small series (approximately 300 patients in total) treated with DES in LMCA have been encouraging, especially for lesions at the ostium and in the left main shaft. Before changes are made in the guidelines for treatment, we must wait for a refinement in the technique and stent design used for bifurcational left main lesion and the results of randomized, specific multicenter studies (SYNTAX trial). It is likely that, for selected patients, LMCA stenosis will be regarded as an indication for PCI.
((J Interven Cardiol 2005;18:455-465).)

المؤلفون: Di Mario C; Royal Brompton Hospital, London, UK. c.dimario@rbh.nthames.nhs.uk, Griffiths H, Goktekin O, Peeters N, Verbist J, Bosiers M, Deloose K, Heublein B, Rohde R, Kasese V, Ilsley C, Erbel R

المصدر: Journal of interventional cardiology [J Interv Cardiol] 2004 Dec; Vol. 17 (6), pp. 391-5.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Wiley Country of Publication: United States NLM ID: 8907826 Publication Model: Print Cited Medium: Print ISSN: 0896-4327 (Print) Linking ISSN: 08964327 NLM ISO Abbreviation: J Interv Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Magnesium*/pharmacology , Stents*, Coronary Restenosis/*prevention & control , Graft Occlusion, Vascular/*prevention & control, Absorbable Implants ; Animals ; Humans ; Hyperplasia/prevention & control ; Models, Animal ; Prosthesis Design ; Stainless Steel ; Tunica Intima/pathology

مستخلص: Current stent technology is based on the use of permanent implants that remain life long in the vessel wall, far beyond the time required for the prosthesis to accomplish its main goals of sealing dissection and preventing wall recoil. With the possibility to implant long vessel segments using antiproliferative drugs to prevent restenosis, the practice of transforming the coronary vessels into stiff tubes with a full metal jacket covering all side branches and being unable to adjust to the long-term wall changes, including wall remodeling with lumen ectasia becomes a serious concern. In this article, we describe the first biodegradable stent based on a magnesium alloy that allows controlled corrosion with release to the vessel wall and the blood stream of a natural body component such as magnesium with beneficial antithrombotic, antiarrhythmic, and antiproliferative properties. We also discuss the animal experiments and the initial clinical applications in 20 patients with implants below the knee, with final results soon to be released, and the plans for the first coronary study. The results of these last two studies will indicate whether the absence of a permanent implant and the antiproliferative properties shown in animals are sufficient to prevent the restenotic process in humans or whether the prosthesis must be modified by adding the biodegradable coating with conventional antiproliferative drugs.