Background—Blood transfusion is associated with acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). We sought to elucidate in more detail the relation between blood transfusion and AKI and its effects on short- and long-term mortality. Circulation: Cardiovascular Interventions. 2012; 5: 680-688 Published online before print October 9, 2012, doi: 10.1161/CIRCINTERVENTIONS.112.971291. Copyright © 2012 American Heart Association, Inc. All rights reserved.
Background—We have sometimes noted abnormal angiographic coronary dilatation, <50% of the reference vessel, at the site of sirolimus-eluting stent implantation, suggesting contrast staining outside the stent struts and named this finding peri-stent contrast staining (PSS). Little was known about optical coherence tomography findings of lesions with PSS. Circulation: Cardiovascular Interventions. 2012; 5: 649-656 Published online before print September 25, 2012, doi: 10.1161/CIRCINTERVENTIONS.112.968487. Copyright © 2012 American Heart Association, Inc. All rights reserved.
Background—Stent fracture (SF) after drug-eluting stent implantation has recently become an important concern because of its potential association with in-stent restenosis and stent thrombosis. However, the incidence and clinical impact of SF after everolimus-eluting stent implantation remain unclear. Circulation: Cardiovascular Interventions. 2012; 5: 663-671 Published online before print September 25, 2012, doi: 10.1161/CIRCINTERVENTIONS.112.969238. Copyright © 2012 American Heart Association, Inc. All rights reserved.
It is widely accepted that venous thromboemboli can gain access to the left atrium through a patent foramen ovale (PFO). In stroke patients, this mechanism is generally presumed when no other source of stroke is found and a PFO is discovered. Rarely is a thrombus caught straddling the interatrial septum across a PFO. Stroke. 2012; 43: 3147-3149 Published online before print September 18, 2012, doi: 10.1161/STROKEAHA.112.659599. Copyright © 2012 American Heart Association, Inc. All rights reserved.
It is accepted that polymer breakdown occurs through various mechanisms, but for the purpose of this article the exact terminology has been simplified and bioabsorbable will be used to describe all mechanisms of polymer breakdown. Early investigations noted a wide range of vascular inflammatory response to different bioabsorbable polymers. However, in a separate investigation it was noted that high molecular weight poly-L-lactic acid caused no acute or chronic inflammation in porcine coronary arteries.[18] It should also be noted that despite a possible proinflammatory stimulus the polymer will completely degrade within 6–9 months, usually through hydrolysis to leave only a BMS in situ. This has subsequently led to large multicenter investigations of next-generation DES utilizing bioabsorbable polymers.
Background: The aim of this study is to compare the safety, efficacy and durability of Sirolimus (SES), Paclitaxel (PES), Zotarolimus (ZES-R/ Endeavor Resolute), BiolimusA9 (BES), EPC capture (ECS) and Everolimus-eluting stent (EES) on the outcome of patients with left main coronary arteries (LMT) stenosis
Aims: This study reports the 12-month clinical outcomes of the LEADERS clinical trial which compared a biolimus eluting stent with a biodegradable polymer (BES) to a sirolimus eluting stent with a durable polymer (SES).
Aims: Long lesions and complex vessel anatomy frequently require the use of overlapping stents to treat a lesion. The purpose of this study was to evaluate the long-term effects of overlapping the Axxess Biolimus A9™ eluting stent (BES) with two of the most commonly used, commercially available drug eluting stents. These stents were compared to BxVelocity bare metal (BMS) stents in a porcine coronary stent-injury model.
Abstract: The purpose of this study is to demonstrate safety and effectiveness of the S-Stent in de novo coronary lesions treated with conventional percutaneous coronary balloon angioplasty. Between January 2000 and June 2001, 120 patients were prospectively enrolled at four study centers. Patients were treated with coronary stenting in a total of 137 lesions. Procedural success was achieved in 100% of 137 attempted lesions. Clinical success was 99.8%. In-hospital mortality was 0.8%; myocardial infarction occurred in 0.8% and stent thrombosis in 0.8%. After stent implantation, the minimal lumen diameter increased from 0.92 ± 0.43 to 2.74 ± 0.36 mm (P < 0.0001) and the percent diameter stenosis decreased from 68.0 ± 16.2 to 4.5 ± 12.0 (P < 0.0001). At 6-month follow-up, the percent diameter stenosis was 33.5 ± 21.3 and the angiographic restenosis rate was 16.5%. Target lesion revascularization was required in 12 patients (10.1%). We conclude that the use of S-Stent for coronary intervention resulted in a high procedural success rate and low angiographic restenosis at 6 months after implantation. Catheter Cardiovasc Interv 2004;62:439–444. © 2004 Wiley-Liss, Inc.
Drug-eluting stent technology consisting of a bare metal stent, carrier coating, bioactive drug and delivery system, offers an almost infinite range of possible device configurations. A growing understanding of the mechanisms of restenosis allows for the design of synergistic functions within these components, thus providing a basis for new and improved products. The BioMatrix® stent (Biosensors Interventional Technologies Pte Ltd., Singapore) elutes the new sirolimus derivative Biolimus A9® from a biodegradable polylactic acid polymer. Biolimus A9 possesses enhanced anti-inflammatory and antiproliferative activity with an improved pharmacokinetic profile. Permanent polymer-carrier-based platforms may be associated with inflammation, late thrombosis and restenosis. The BioMatrix, with its asymmetric and abluminal coating, releases Biolimus A9 into the vessel wall while the polylactic acid polymer is resorbed by surrounding tissues. Clinical studies have demonstrated the BioMatrix to be well tolerated and effective, and it has now become the subject of an aggressive clinical program.
Objectives: The STEALTH (STent Eluting A9 BioLimus Trial in Humans) trial was the first-in-man study to assess the safety and efficacy of the bioabsorbable-polymer-coated Biolimus A9™-eluting BioMATRIX™-Stent, as compared to a bare metal stent control (S-Stent™).
Patients with multi-vessel disease, diabetes and bifurcation lesions are among some of the most difficult lesion subgroups to treat effectively with percutaneous coronary intervention. Historically, bifurcation lesion location has been shown to be a predictor for major adverse cardiac events1. More recent studies of PCI using drug eluting stents (DES) in bifurcation lesions show that while target lesion revascularisation (TLR) rates are reduced, these lesions continue to be difficult to classify, difficult to treat, and associated with elevated complication rates such as periprocedural non-Q-wave MI2, side branch occlusion, and stent thrombosis3. These problems are not likely to be solved by procedure modifications alone; stent design modifications will play a role as well.
Aims: Lesion length remains a predictor of target lesion revascularisation and results of long lesion stenting remain poor. Sirolimus-eluting stents have been shown to perform better than paclitaxel eluting stents in long lesions. In this substudy of the LEADERS trial, we compared the performance of biolimus biodegradable polymer (BES) and sirolimus permanent polymer stents (SES) in long lesions.
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