Seminars in interventional cardiology : SIIC最新文献

{"title":"Coated and active stents: an introduction.","authors":"W J van der Giessen, R S Schwartz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"125-6"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21273089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic stent coatings: hirudin/iloprost combination.","authors":"E Alt,&nbsp;C Seliger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neointimal formation after stent implantation can cause luminal narrowing, called restenosis. Restenosis is induced by initial platelet adhesion and thrombus formation followed by immunocyte adhesion on the stent surface and on the injured vessel wall. The thrombus releases factors, which activates the proliferation of smooth muscle cells. Stents, coated with an antithrombotic surface, may prevent platelet adhesion and subsequent smooth muscle cell proliferation. This paper will review stent coating with poly-LD-lactic acid, a biodegradable polymer containing Iloprost, a synthetic prostacycline, and PEG-Hirudin as a method for reducing of restenosis.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"177-83"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21274158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomimicry 1: PC.","authors":"D C Cumberland,&nbsp;J Gunn,&nbsp;N Malik,&nbsp;C M Holt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The surface properties of stents can be modified by coating them, for example with a polymer. Phosphorylcoline (PC) is the major component of the outer layer of the cell membrane. The haemo- and biocompatibility of a PC-containing polymer is thus based on biomimicry, and has been confirmed by several experiments showing much reduced thrombogenicity of PC-coated surfaces, and porcine coronary artery implants showing no sign of adverse effect. Clinical experience with the PC-coated BiodivYsio appears favourable. The PC coating can be tailored for take up and controlled elution of various drugs for stent-based local delivery, a property which is being actively explored.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"149-50"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21273093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene therapy to prevent restenosis, the Boston experience.","authors":"R A Tio,&nbsp;J M Isner,&nbsp;K Walsh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The delivery of genetic material to the vessel wall is being explored as a means to treat disorders of the vasculature. Gene therapy offers the possibility to directly or indirectly influence the molecular pathways that are disregulated. With regard to postangioplasty restenosis, gene therapy is most often aimed at inhibition of vascular smooth muscle cell (VSMC) proliferation. Here, we review the results of studies in our laboratories that have investigated a number of different strategies to inhibit proliferative vessel wall lesions. These strategies include the administration of genes that block cell cycle progression, induce apoptosis, or promote the growth of vascular endothelium.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"205-10"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21274159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic polymers.","authors":"H M van Beusekom,&nbsp;R S Schwartz,&nbsp;W J van der Giessen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For several decades, synthetic polymers have been the subject of study for vascular applications. Several materials have been tested to date, both for coating and replacing metal stents. While conflicting data between some of these studies exist, these may in part be related to characteristics secondary to the synthetic polymer itself: surface characteristics (roughness, porosity, contaminants), bulk, fragmentation and degradation rate in the case of bioabsorbable polymers. Knowledge of the healing characteristics of the coated stents or stent grafts are essential for successful long-term results.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"145-8"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21273091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene therapy for coronary artery disease: The University of Michigan Program.","authors":"H J Duckers,&nbsp;E G Nabel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent studies show that the cyclin dependent kinase inhibitor KIP/CIP family members function as regulators of VSMC proliferation. The prevention and treatment of cell proliferation in arteries after percutaneous intervention, represents an attractive target for gene therapy. Targeting of cell cycle regulatory proteins might inhibit cell proliferation and migration, and induce withdrawal from the cell cycle. Furthermore, these studies suggest that genetic approaches are feasible and that local expression of a regulatory gene is sufficient to abrogate lesion formation in different animal models of vascular diseases.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"201-4"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21274161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coated stents: local pharmacology.","authors":"V K Raman,&nbsp;E R Edelman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite excellent restoration of acute vessel perfusion, coronary stenting has been limited by subacute thrombosis within 3-10 days and by neointimal proliferation leading to restenosis by 6 months post-intervention. A variety of pharmacotherapeutics have been utilized in an attempt to prevent these sequelae. Drug regimens that reduce thrombosis have the potential for serious toxicities, and no regimen to date has been shown clinically to reduce the incidence of restenosis. Local drug delivery via stents coated with immobilized drug or coated with a drug-releasing polymer matrix offers the possibility of focal therapeutic drug effect within target tissues without serious side-effects arising from systemic drug administration. Before the promise of this treatment modality is realized, however, a more detailed understanding is needed of the local pharmacologic influences on drug activity. Drug-device parameters, such as stent surface area and mode of drug attachment, and drug-tissue parameters, including drug solubility in and non-specific binding to tissues, interact in a complex manner to determine local tissue drug dose, distribution and, consequently, effect.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"133-7"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21273087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative pathology: radiation-induced coronary artery disease in man and animals.","authors":"R Virmani,&nbsp;A Farb,&nbsp;A J Carter,&nbsp;R M Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The occurrence of coronary artery disease following mediastinal radiation for malignancies has long been debated. However, the development of coronary pathology in young individuals following radiation who lack risk factors for atherosclerosis is highly suggestive of a cause-and-effect relationship. By far the most convincing pathologic changes are adventitial scarring and medial atrophy with severe intimal atherosclerotic disease consisting of necrotic core, fibrous tissue, and calcification. Initial clinical studies in patients with coronary atherosclerosis treated with intraluminal radiation following stenting hold great promise in the treatment and prevention of restenosis. There are little or no data, however, on long-term effects of intra-coronary radiation therapy in man. Therefore, it may be important to study the chronic effects of radiation in animal models in order to predict what is likely to occur in humans. We evaluated the effects of varying doses (0.15-23.0 microCi of 32P) of beta-particle-emitting radioactive stents in pig coronary arteries at 1 and 6 months. At 1 month, there were dose-dependent changes in the morphology of the intima and media. High activities (>3 microCi) caused medial necrosis with fibrin deposition in the media and intima, with interspersed red cells most marked in regions surrounding the stent struts. Only rare smooth muscle cells (SMCs) and inflammatory cells were seen away from the stent struts. In the intermediate (1 microCi) stent activity group, the neointima was expanded by SMCs and a proteoglycan-rich matrix with focal endothelialization of the luminal surface. Neovascular capillaries and extravascular red cells were present adjacent to stent struts. At low activities (<0.5 microCi), the neointima was significantly smaller than control stents and consisted of SMCs and matrix with complete endothelialization of the luminal surface. The neointimal cell density of the media and intima decreased with increasing doses of radiation. In pigs 6 months after radioactive stenting (activities ranging from 0.5-12 microCi 32P), >3.0 microCi radioactive stents induced marked neointimal thickening, with changes similar to atherosclerosis, consisting of necrotic debris containing cholesterol clefts surrounded by macrophage collections, fibrosis, and focal calcification. There was increased adventitial thickening in the radiated vs non-radiated arteries. The intermediate stent activity (1.0 microCi) also showed greater neointimal thickening (vs control stents) and consisted mostly of SMCs in a proteoglycan-rich matrix. At <1.0 microCi, there were minimal differences seen between radiated and control non-radiated stented arteries. The media was unevenly injured in all stent activities and varied from less than to significantly greater than controls. These data suggest that radiation-induced coronary atherosclerosis seen in man is partially simulated in normal porcine coronary arteries 6 months following high-dos","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"163-72"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21274157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiproliferative stent coatings: Taxol and related compounds.","authors":"C Herdeg,&nbsp;M Oberhoff,&nbsp;K R Karsch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The implantation of stents can prevent vessels from post interventional elastic recoil and appears to limit adverse remodelling. In order to inhibit in-stent restenosis, an additional release of antiproliferative agents from the stent itself might lead to a synergistic reduction of lumen renarrowing. Paclitaxel (Taxol) is a microtubule-stabilizing agent with potent antiproliferative activity. Unlike other antimitotic agents of the colchicine type, it shifts the microtubule equilibrium towards assembly, leading to reduced proliferation, migration and signal transduction. Moreover, important biological processes, such as the activation of some protein kinases, are associated with microtubule depolymerization and are therefore inhibited by paclitaxel. Several experimental in vitro and in vivo studies using local paclitaxel delivery to inhibit proliferation and lumen renarrowing have been performed already--with very encouraging results.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"197-9"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21274163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomimicry, vascular restenosis and coronary stents.","authors":"R S Schwartz,&nbsp;W J van der Giessen,&nbsp;D R Holmes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Biomimicry is in its earliest stages and is being considered in the realm of tissue engineering. If arterial implants are to limit neointimal thickening, purely passive structures cannot succeed. Bioactivity must be present, either by pharmacologic intervention or by fabricating a 'living stent' that contains active cellular material. As tissue engineering evolves, useful solutions will emerge from applying this knowledge directly to vascular biologic problems resulting from angioplasty, stenting, and vascular prosthesis research.</p>","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 3-4","pages":"151-6"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21273092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}