International journal of cardiovascular interventions最新文献

{"title":"Single vs multivessel treatment during primary angioplasty: results of the multicentre randomised HEpacoat for cuLPrit or multivessel stenting for Acute Myocardial Infarction (HELP AMI) Study.","authors":"Carlo Di Mario,&nbsp;Sansa Mara,&nbsp;Airoldi Flavio,&nbsp;Sheiban Imad,&nbsp;Manari Antonio,&nbsp;Petronio Anna,&nbsp;Piccaluga Emanuela,&nbsp;De Servi Stefano,&nbsp;Ramondo Angelo,&nbsp;Colusso Stefania,&nbsp;Formosa Anna,&nbsp;Cernigliaro Carmelo,&nbsp;Colombo Antonio,&nbsp;Nicoletta Monzini,&nbsp;Maria Antonietta Bonardi","doi":"10.1080/14628840310030441","DOIUrl":"https://doi.org/10.1080/14628840310030441","url":null,"abstract":"<p><strong>Design: </strong>Prospective randomized, multicentre study.</p><p><strong>Rationale: </strong>Recanalisation of the culprit lesion is the main goal of primary angioplasty for acute myocardial infarction. With the exception of cardiogenic shock, staged procedures are performed in the presence of multivessel disease. The study hypothesis is that with modern non-thrombogenic stents (heparin coated) complete revascularization with multivessel treatment can be safely achieved during the primary angioplasty procedure with a lower need of subsequent revascularization procedures and at a lower cost.</p><p><strong>Endpoints: </strong>PRIMARY: 12-month incidence of repeat revascularization (any revascularization, infarct related artery as well as non-infarct-related artery). SECONDARY: (1) in hospital repeat revascularization, reinfarction and death; (2) total hospital cost (including a 12 months follow-up period).</p><p><strong>Methods: </strong>69 patients with ST elevation Acute Myocardial Infarction (AMI), <12 hours after symptoms onset, undergoing primary angioplasty, with documented multivessel disease and both culprit lesion and 1 to 3 other lesions suitable for stent implantation. Unbalanced randomization between culprit lesion treatment only (n = 17) and complete multivessel treatment (n = 52, with 71 additional lesions treated).</p><p><strong>Results: </strong>The two groups were well balanced in terms of clinical characteristics, number of diseased vessels and angiographic characteristics of the culprit lesion. In the complete multivessel treatment group 2.36 +/- 0.64 lesions per patient were treated using 2.73 +/- 0.78 heparin coated stents (1.00 lesions and 1.29 +/- 0.61 stents in the culprit treatment group, both p < 0.001). The duration of the procedure increased from 53 +/- 21 min (culprit treatment group) to 69 +/- 32 min (p = 0.032) and the amount of contrast used from 242 +/- 102 ml (culprit treatment group) to 341 +/- 163 ml (multivessel complete treatment), p = 0.025. A similar low incidence of in-hospital major adverse cardiac events was observed in the 2 groups (0 and 3.8% in culprit and multivessel treatment groups, p = 0.164). The increase in the incidence of new revascularisation in the culprit treatment group at 12 month follow-up was not significant (35 vs 17%, p = 0.247) but was sufficient to compensate the initial higher in-hospital cost, with a similar 12 month hospital cost in the 2 groups (Euro 22,330 +/- Euro 13,653 vs Euro 20,382 +/- Euro 11,671, p = 0.231).</p><p><strong>Conclusion: </strong>Multivessel treatment during primary PTCA was safe in this controlled trial. However, when only the culprit lesion was initially treated, the need for subsequent clinically driven revascularization remained low and no clinical or economical advantages were obtainable with a more aggressive initial approach. In clinical practice, a staged approach to multivessel treatment during primary angioplasty avoids to treat unnecessa","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"128-33"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840310030441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24997032","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":"A prospective multicentre registry of the procedural and long-term clinical and angiographic results of stent implantation using a Dylyn coated coronary stent system.","authors":"Robert Riezebos,&nbsp;Eelko Ronner,&nbsp;Ferdinand Kiemeneij,&nbsp;Gert-Jan Laarman","doi":"10.1080/14628840310030450","DOIUrl":"https://doi.org/10.1080/14628840310030450","url":null,"abstract":"<p><strong>Objectives: </strong>A prospective registry was performed to evaluate the safety and efficacy of a Dylyn coated coronary stent.</p><p><strong>Background: </strong>Diamond-like nanocomposite (Dylyn) stent coating is thought to be biocompatible, resulting in decreased thrombogenicity and decreased neointimal hyperplasia.</p><p><strong>Methods: </strong>In a multicentre, open, prospective, clinical and angiographical registry, the Dylyn-coated stent system was evaluated in patients requiring percutaneous coronary intervention. The primary procedural and angiographical endpoint of the study was the sustained success of stent-implantation using a follow-up catheterisation at six months. The primary clinical endpoint of the study was the composite incidence of death, non-fatal myocardial infarction and revascularisation at six months after stent implantation.</p><p><strong>Results: </strong>127 Dylyn coated coronary stents were implanted in 121 patients. Procedural success was obtained in 100% of the cases. No episodes of acute stent thrombosis occurred. The number of patients within stent restenosis at six months was 29 (24%). The primary procedural, angiographical endpoint was achieved in 91 (70%) patients. The clinical results at six-month follow-up were favourable with a MACE-rate of 7.4%.</p><p><strong>Conclusions: </strong>A Dylyn coated coronary stent system is well tolerated and has excellent short-term results. The amount of angiographic restenosis at 6 months, however, is considerable, but comparable to other non-drug-eluting stent systems.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"137-41"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840310030450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24997034","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":"Intracoronary beta-irradiation enhances balloon-injury-induced tissue factor expression in the porcine injury model.","authors":"Ariel Finkelstein,&nbsp;Joerg Hausleiter,&nbsp;Terence Doherty,&nbsp;Kaname Takizawa,&nbsp;Jonathan Bergman,&nbsp;Ming Liu,&nbsp;Vladimir Rukshin,&nbsp;Michael Fishbein,&nbsp;Neal Eigler,&nbsp;Prediman Shah,&nbsp;Tripathi Rajavashisth,&nbsp;Raj Makkar","doi":"10.1080/14628840410030351","DOIUrl":"https://doi.org/10.1080/14628840410030351","url":null,"abstract":"<p><p>Intracoronary brachytherapy (ICBT) effectively reduces restenosis but is associated with late thrombosis. Since tissue factor (TF) is an important mediator of arterial thrombosis, we tested the hypothesis that ICBT results in persistently augmented TF expression. Coronary arteries from 12 pigs were randomized to: control (C; no injury), oversized balloon injury (BI), or BI followed by ICBT. Animals were sacrificed at 1, 7, 14, or 60 days postprocedure, and coronary arteries collected for expression analyses and immunostaining. ICBT-treated arteries had higher TF antigen and activity at all time-points compared to BI arteries (Western blot: 16 571 +/- 2090 vs 10 135 +/- 2939 densitometric units, p = 0.001; ELISA: 0.42 +/- 0.13 nM vs 0.25 +/- 0.14 nM, p = 0.001; TF activity assay: 0.303 +/- 0.11 nM vs 0.18 +/- 0.07 nM, p = 0.01; immunohistochemical staining: 30.6 +/- 6.6% vs 11.5% +/- 3.2%, p = 0.01). TF expression increased following BI, increased further following ICBT, and persisted for the duration of the study. We conclude that TF expression increases after BI, but is further increased and persists for a longer duration following ICBT, suggesting that a TF-mediated mechanism may play a role in late thrombosis following ICBT.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"20-7"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24572022","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":"Clinical experiences using the FilterWire EX for distal embolic protection during complex percutaneous coronary interventions.","authors":"Eli Lev,&nbsp;Igal Teplitsky,&nbsp;Shmuel Fuchs,&nbsp;Nurit Shor,&nbsp;Abid Assali,&nbsp;Ran Kornowski","doi":"10.1080/14628840310022117","DOIUrl":"https://doi.org/10.1080/14628840310022117","url":null,"abstract":"<p><strong>Background: </strong>Distal embolization during coronary angioplasty may result in vessel occlusion, no reflow and myonecrosis. This study tested the authors' clinical experiences using a guidewire system designed to preserve distal flow during angioplasty.</p><p><strong>Methods and results: </strong>The FilterWire EX trade mark (Boston Scientific, Natick, MA, USA) consists of a 0.014-inch guidewire on which an expandable loop structure is attached to a porous polyurethane membrane. The assembly is delivered across the target lesion, followed by deployment of the filter distal to the lesion. Procedural and angiographic outcome data were obtained from patients undergoing saphenous vein grafts (SVGs) (n = 16) or native coronary (n = 4) interventions. The mean age was 62 +/- 10 years. All four patients with native coronary lesions sustained acute myocardial infarction while 15/16 patients with degenerated SVGs presented with accelerated angina pectoris. The mean proximal reference diameter was 3.62 +/- 0.32 mm, percentage diameter stenosis was 72 +/- 13%, and lesion length was 16.3 +/- 5.7 mm. Angiographic visible thrombus was detected in 12/20 (60%) cases. Stents were used in 19/20 patients (95%) with average stent diameter/length equal to 3.81 +/- 0.42/23 +/- 7 mm. Overall procedural success was obtained in 93.3% as no-reflow and total CK elevation occurred in 1/16 treated patients (6.7%) despite distal embolic filtration. In-hospital and 30-day survival was 100% with no episodes of target vessel thrombosis and/or myocardial infarction.</p><p><strong>Conclusions: </strong>The use of the FilterWire EX seems to be feasible and safe in suitable lesion subsets and in relatively large-sized vessels among patients who are at high risk for distal embolization.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840310022117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24572023","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":"Traumatic ostial stenosis of internal mammary coronary graft.","authors":"Jan Van der Heyden,&nbsp;Glenn Van Langenhove,&nbsp;Paul Vermeersch","doi":"10.1080/1462884031000","DOIUrl":"https://doi.org/10.1080/1462884031000","url":null,"abstract":"<p><p>Because of the extensive use of arterial conduits for coronary surgery there is a growing interest in percutaneous intervention in these conduits. This kind of intervention presents a challenge for the interventional cardiologist owing to the anatomic and functional characteristics of this graft. In most cases significant internal mammary artery disease occurs at the distal anastomosis. Ostial stenoses are rare and their pathology uncertain. The authors report a case of an ostial graft lesion, most probably caused by repetitive ostial engagement of the left internal mammary artery in combination with atherosclerosis in the subclavian artery affecting the internal mammary artery.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"42-4"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/1462884031000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24570792","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":"Histopathologic evaluation of a novel-design nitinol stent: the Biflex stent.","authors":"Stefan Verheye,&nbsp;Guido De Meyer,&nbsp;Koen Salu,&nbsp;Michiel Knaapen,&nbsp;Mark Kockx","doi":"10.1080/14628840410030342","DOIUrl":"https://doi.org/10.1080/14628840410030342","url":null,"abstract":"<p><strong>Background: </strong>Optimalization and improvement in stent material, stent design and deployment may alleviate the problem of restenosis after stenting. The Biflex stent is a novel-design stent made of nitinol; the vascular response after deployment in rabbit iliac arteries was evaluated.</p><p><strong>Methods and results: </strong>Normocholesterolemic New Zealand white rabbits (n = 8) were used. Iliac arteries were randomized to receive either a stainless steel control stent or a nitinol stent and rabbits were euthanized at 30 days after implantation. All animals survived and there were no adverse events. Vessels were harvested and prepared for histopathologic analysis and histomorphometry. Stents were well opposed to the vessel wall and thrombi were absent. The lumen area and the area within the internal elastic lamina were significantly larger in the nitinol stent group as opposed to the control group (3.8 +/- 0.1 vs 3.3 +/- 0.1 mm, p = 0.009 and 4.6 +/- 0.1 vs 4.1 +/- 0.2 mm, p = 0.03, respectively). There were no differences in injury score, neointimal area, medial area, area within the external elastic lamina and amount of inflammatory cells. Staining for alpha-smooth muscle cell actin and endothelium did not show any differences between the two groups as assessed semiquantitatively.</p><p><strong>Conclusion: </strong>This nitinol stent with a novel design demonstrated acceptable biocompatibility in iliac arteries of normocholesterolemic rabbits with minimal foreign-body reaction and minimal neointimal formation.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"13-9"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24572021","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":"The percutaneous assessment of regional and acute coronary hot unstable plaques by thermographic evaluation (PARACHUTE) study: a prospective reproducibility and prognostic clinical study using thermography to predict future ischemic cardiac events.","authors":"Stefan Verheye,&nbsp;Glenn Van Langenhove,&nbsp;Gerrit-Anne van Es,&nbsp;Patrick Serruys","doi":"10.1080/14628840410030397","DOIUrl":"https://doi.org/10.1080/14628840410030397","url":null,"abstract":"<p><p>Intravascular thermography is currently being considered as a valuable tool in assessing macrophage-rich plaques. Since it is unknown what the prognostic value is of non-obstructive atherosclerotic plaques showing temperature heterogeneity, we designed the PARACHUTE study, a prospective, reproducibility, and prognostic clinical study using thermography in patients presenting with an unstable coronary syndrome. The primary endpoint of the study is the predictive value of temperature heterogeneity towards the occurrence of ischemic coronary events and hospitalization for ischemia and/or angina. The secondary endpoints are the predictive value of high-risk plaques associated with the development of future cardiac events, assessment of safety of the procedure, assessment of temperature reproducibility and heterogeneity in coronary arteries, as defined by the total thermal burden towards the occurrence of any cardiac event. Based on an event rate of death and myocardial infarction at 1 year of 10%, a sample size of 260 patients with presumed coronary artery disease, and positive troponin level who are scheduled to undergo an intervention will be included. All three main epicardiac vessels will undergo angiography and thermography at baseline after revascularization of the flow-limiting vessel. At 12 months, angiography of all vessels and thermography of the vessel with the highest thermographic burden will be performed. Independent core laboratories will assess outcomes and a clinical endpoint committee will assess clinical events.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 2","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24697896","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":"World Heart Federation publishes the first internatiConal principles for cardiovascular disease prevention","authors":"Lauren O'brien","doi":"10.1080/1462884031000-1","DOIUrl":"https://doi.org/10.1080/1462884031000-1","url":null,"abstract":"","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"54 1","pages":"93 - 93"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76485950","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":"The AngioGuard: a simplified snare?","authors":"Ahmed A Khattab,&nbsp;Volker Geist,&nbsp;Ralph Toelg,&nbsp;Gert Richardt","doi":"10.1080/14628840410030469","DOIUrl":"https://doi.org/10.1080/14628840410030469","url":null,"abstract":"<p><p>We describe a case of successful retrieval of a lost intracoronary stent using the ANGIOGUARD XP emboli retraction guidewire system (Cordis Corporation) as a safe and innovative method for management of this critical issue in an 80-year old male patient.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"153-5"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25289454","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":"Inflammatory markers: linking unstable plaques to coronary event, an interventional perspective.","authors":"Doron Aronson","doi":"10.1080/14628840410030522","DOIUrl":"https://doi.org/10.1080/14628840410030522","url":null,"abstract":"<p><p>Abundant data links inflammatory mechanisms to atheromatous plaque destabilization leading to plaque rupture and coronary events. The discovery of inflammatory cells and inflammatory mediators within atherosclerotic plaques prone to rupture led to a series of studies demonstrating an association between various markers of inflammation and future coronary events. Inflammatory markers have also been used in patients undergoing coronary angioplasty in an attempt to predict restenosis and risk for post-procedural coronary events. This review article provides an overview on the potential use of inflammatory markers in the context of coronary interventions.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"110-8"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030522","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24997030","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}