Stents coronary

Administration (FDA) approval of SIBS, used as the polymeric coating on the Taxus coronary stent, opened new avenues for polyisobutylene-based TPEs in biomedical engineering. 

US FDA. Taxus Express 2 PacUtaxel-Eluting Coronary Stent System (Monorail and Over the Wire), P030025, 2004. 

Elevated homocysteine concentrations have been associated with an increased risk for cardiovascular disease in both epidemiologic and clinical studies.43 Several studies have evaluated the benefit of lowering homocysteine levels with folic acid supplementation. One study reported a reduction in major cardiac events with the combination of folic acid, vitamin B12, and vitamin B6 following PCI.44 However, a more recent study found an increased risk of instent restenosis and the need for target-vessel revascularization with folate supplementation following coronary stent placement.45 The role of folate in the management of IHD is currently unclear. 

The AHA/ASA guidelines recommend that antiplatelet therapy as the cornerstone of antithrombotic therapy for the secondary prevention of ischemic stroke and should be used in noncardioembolic strokes. Aspirin, dopidogrel, and extended-release dipyridamole plus aspirin are all considered first-line antiplatelet agents (see Table 13-1). The combination of aspirin and clopido-grel can only be recommended in patients with ischemic stroke and a recent history of myocardial infarction or coronary stent placement and then only with ultra-low-dose aspirin to minimize bleeding risk. 

Betriu A, Masotti M, Serra A, et al. Randomized comparison of coronary stent implantation and balloon angioplasty in the treatment of de novo coronary artery lesions (START) a four-year follow-up. J Am Coll Cardiol 1999 34 1498-1506. 

Martinez-Elbal L, Ruiz-Nodar JM, Zueco J, et al. Direct coronary stenting versus stenting with balloon pre-dilation immediate and follow-up results of a multicentre, prospective, randomized study. The DISCO trial. Direct stenting of coronary arteries. Eur Heart J 2002 23 633-640. 

Kjelsberg MA, Seifert P, Edelman ER, Rogers C. Design-dependent variations in coronary stent stenosis measured as precisely by angiography as by histology. J Invasive Cardiol 1998 10 3b llb. 

Inoue T, Sohma R, Miyazaki T, Iwasaki Y, Yaguchi I, Morooka S. Comparison of activation process of platelets and neutrophils after coronary stent implantation versus balloon angioplasty for stable angina pectoris. Am J Cardiol 2000 86 1057-1062. 

Fukuda D, Shimada K, Tanaka A, Kawarabayashi T, Yoshiyama M, Yoshikawa J. Circulating monocytes and in-stent neointima after coronary stent implantation. J Am Coll Cardiol 2004 43 18-23. 

Walter DH, Fichtlscherer S, Sellwig M, Auch-Schwelk W, Schachinger V, Zeiher AM. Preprocedural C-reactive protein levels and cardiovascular events after coronary stent implantation. J Am Coll Cardiol 2001 37 839-846. 

Zairis MN, Ambrose JA, Manousakis SJ, et al. The impact of plasma levels of C-reactive protein, lipoprotein (a) and homocysteine on the long-term prognosis after successful coronary stenting the Global evaluation of new events and restenosis after stent implantation study. J Am Coll Cardiol 2002 40 1375-1382. 

Kastrati A, Koch W, Berger PB, et al. Protective role against restenosis from an interleukin-1 receptor antagonist gene polymorphism in patients treated with coronary stenting. J Am Coll Cardiol 2000 36 2168-2173. 

Zotarohmus (53 EndeavorT stent ABT-578 Medtronic, 2005), a semisynthetic derivative of sirolimus (34), was designed for use in stents with phosphorylcholine as a carrier coronary stents reduce early complications... 

Fischman DL, Leon MB, Bairn DS, et al., for the Stent Restenosis Study Investigators. A randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994 331 496-501. 

Serruys P, Ong A, van Herwerden L, et al. Five-year outcomes after coronary stenting versus bypass surgery for the treatment of multivessel disease. J Am Coll Cardiol 2005 46 575-581. 

Cutlip DE, Chauhan MS, Bairn DS, et al. Clinical restenosis after coronary stenting perspectives from multicenter trials. J Am Coll Cardiol 2002 40 2082-2089. 

Hausleiter J, Kastrati A, Mehili J, et al. Predictive factors for early cardiovascular events and angiographic restenosis after coronary stent placement in small coronary arteries. J Am Coll Cardiol 2002 40 882-889. 

Kobayashi Y, Honda Y, Christie LG, et al. Long-term vessel response to a self-expanding coronary stent a serial volumetric intravascular ultrasound analysis from the ASSURE trial. J Am Coll Cardiol 2001 1329-1334. 

McFadden EP, Stabile E, Regar E, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet 2004 364 1519-1521. 

Tamai H, Igaki K, Tsuji T, et al. A biodegradable poly-L-lactic acid coronary stent in porcine coronary artery. J Interv Cardiol 1999 12 443-450. 

Ormiston J, Serruys PW, Regar E, et al. A bioabsorb-able everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions (ABSORB) a prospective open-label trial. Lancet 2008 371 899-907. 

However, the trial raised important safety questions. Intracoronary infusion of G-CSF-stimulated peripheral-blood stem cells apparently aggravated restenosis after coronary stenting, leading to early termination of the trial. Meanwhile, no temporal association between increased restenosis rate and stenting near the time of intracoronary cell administration has been noted in other studies that have not used G-CSF stimulation. 

Kang HJ, Kim HS, Zhang SY, Park KW, Cho HJ, Koo BK, Kim YJ, Soo Lee D, Soon DW, Han KS, Oh BH, Lee MM, Park YB. Effects of intracoronary infusion of peripheral blood stem-cells mobilised with granulocyte-colony stimulating factor on left ventricular systolic function and restenosis after coronary stenting in myocardial infarction the MAGIC cell randomised clinical trial. Lancet 2004 363 751-756. 

Topol EJ, Mark DB, Lincoff AM, Cohen E, Burton J, Kleiman N et al. Outcomes at 1 year and economic imphcations of platelet glycoprotein Ilb/IIIa blockade in patients undergoing coronary stenting results from a multicentre randomised trial. EPISTENT investigators. Evaluation of platelet Ilb/IIIa inhibitor for stenting. Lancet 1999 354 2019-24. 

G. Other applications In patients with acute myocardial infarction, coronary stenting plus ReoPro leads to a greater degree of myocardial salvage and a better clinical outcome than does fibrinolysis with a tissue plasminogen activator. As compared with placebo, early administration of ReoPro in patients with acute myocardial infarction improves coronary patency before stenting, the success rate of the... 

Some patients seem to have an inherent genetic susceptibility to restenosis following coronary stent implantation. Research has shown that patients homozygous for the deletion D) allele of angiotensin converting enzyme ACE) gene polymorphism lack functional enzyme and are at increased risk. These patients have ele-... 

The ACE gene insertion/deletion (ED) polymorphism was characterized in 345 patients who were undergoing coronary stenting. Among them, 115 had the DD genotype. The investigators assigned 91 of these patients to quinapril 40 mg daily or placebo. Treatment was initiated within 48 hours after stent implantation and continued for 6 months. 

Meurice, T., C. Bauters, X. Hermant, V. Codron, E. VanBelle, E.P. Me Fadden, J. Lablanche, M.E. Bertrand, and P. Amouyel, Effect of ACE inhibitors on angiographic restenosis after coronary stenting (PARIS) a randomised, double-blind, placebo-controlled trial. Lancet, 2001. 357(9265) 1321. ... 

Coronary stents Sirolimus (impregnated stent) Good... 

PS/PIB/PS block copolymers have been shown to be vascularly compatible. When loaded with paclitaxel and coated on a coronary stent, the composite can deliver the drug directly to arterial walls. 

The EPISTENT Investigators. Randomized placebo-controlled and balloon-angioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein-l lb/11 la blockade. Lancet 1998 352 87-92. 

Montalescot G, Barragan FJ Wittenberg O, et al., for the ADMIRAL Investigators. Platelet glycoprotein llb/llla inhibition with coronary stenting for acute myocardial infarction. N Engl J Med 2001 344 1895. 

O Shea JC, Buller CE, Cantor WJ, et al. Long-term efficacy of platelet glycoprotein llb/llla integrin blockade with eptifibatide in coronary stent intervention, JAMA 2002 287 618. 

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