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Everolimus-eluting bioresorbable scaffold versus everolimus-eluting metallic stent in primary percutaneous coronary intervention of ST-segment elevation myocardial infarction: a randomized controlled trial. Coron Artery Dis 2023; 34:1-10. [PMID: 36484214 DOI: 10.1097/mca.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary percutaneous coronary intervention with implantation of a metallic drug-eluting stent (DES) is the standard treatment for patients presenting with ST-elevation myocardial infarction (STEMI). Implantation of a bioresorbable scaffold (BRS) during STEMI represents a novel strategy without intravascular metal. OBJECTIVE The aim of the study was to investigate 12-month healing response in an STEMI population after implantation of either the Absorb BRS or Xience DES (Abbott Vascular, USA). METHODS The present trial was a prospective, randomized, controlled, nonblinded, noninferiority study with planned inclusion of 120 patients with STEMI. Patients were randomly assigned 1:1 to treatment with Absorb BRS or Xience DES. Implantation result and healing response were evaluated by angiography and optical coherence tomography (OCT) at baseline and 12-month follow-up. The primary endpoint was minimum flow area (MFA) assessed at 12 months. Coronary stent healing index (CSHI) was calculated from OCT images. RESULTS Out of 66 included patients, 58 had follow-up OCT after 12 months, and 49 entered matched analysis. One death occurred in each group; none were stent-related. MFA was 5.13 ± 1.70 mm2 (95% CI, 4.44-5.82) in the BRS group compared with 6.30 ± 2.49 mm2 (95% CI, 5.22-7.37) (P = 0.06) in the DES group. Noninferiority could not be evaluated. CSHI for both groups had a median score of 3. CONCLUSION The DES group performed numerically better in primary and secondary endpoints, but the CSHI showed good stent healing in both groups.
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Mohamed MO, Sirker A, Chieffo A, Avanzas P, Nolan J, Rashid M, Dafaalla M, Moledina S, Ludman P, Kinnaird T, Mamas MA. Temporal patterns, characteristics, and predictors of clinical outcomes in patients undergoing percutaneous coronary intervention for stent thrombosis. EUROINTERVENTION 2022; 18:729-739. [PMID: 35599596 PMCID: PMC10241267 DOI: 10.4244/eij-d-22-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/12/2022] [Indexed: 10/23/2023]
Abstract
BACKGROUND There are limited data on the outcomes of percutaneous coronary intervention (PCI) following stent thrombosis (ST) and differences exist based on timing. AIMS Our aim was to study the rates of PCI procedures for an ST indication among all patients admitted for PCI at a national level and to compare their characteristics and procedural outcomes based on ST timing. METHODS All PCI procedures in England and Wales (2014-2020) were retrospectively analysed and stratified by the presence of ST into four groups: non-ST, early ST (0-30 days), late ST (>30-360 days), very late ST (>360 days). Multivariable logistic regression models were performed to assess the odds ratios (OR) of in-hospital MACCE (major adverse cardiovascular and cerebrovascular events, a composite of mortality, acute stroke and reinfarction) and mortality. RESULTS Overall, 7,923 (1.4%) procedures were for ST indication, most commonly for early ST (n=4,171; 52.6%), followed by very late ST (n=2,801; 35.4%) and late ST (n=951; 12.0%). The rate of PCI for ST declined between 2014 and 2020 (1.7 to 1.4%; p<0.001). Early ST was the only subgroup associated with increased odds of MACCE (OR 1.22, 95% CI: 1.05-1.41), all-cause mortality (OR 1.21, 95% CI: 1.07-1.36) and reinfarction (OR 2.48, 95% CI: 1.48-4.14), compared with non-ST indication. The odds of mortality were significantly reduced in ST patients with the use of intravascular imaging (OR 0.66, 95% CI: 0.48-0.92) and newer P2Y12 inhibitors (ticagrelor: OR 0.69, 95% CI: 0.49-0.95; prasugrel: OR 0.54, 95% CI: 0.30-0.96). CONCLUSIONS PCI for ST has declined in frequency over a 7-year period, with most procedures performed for early ST. Among the different times of ST onset, only early ST is associated with worse clinical outcomes after PCI. Routine use of intravascular imaging and newer P2Y12 inhibitors could further improve outcomes in this high-risk procedural group.
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Affiliation(s)
- Mohamed O Mohamed
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Alex Sirker
- Department of Cardiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Alaide Chieffo
- Department of Cardiology, San Raffaele Hospital, Milan, Italy
| | - Pablo Avanzas
- Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - James Nolan
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Muhammad Rashid
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Mohamed Dafaalla
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Saadiq Moledina
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Tim Kinnaird
- Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
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Mohamed MO, Kinnaird T, Wijeysundera HC, Johnson TW, Zaman S, Rashid M, Moledina S, Ludman P, Mamas MA. Impact of Intracoronary Imaging-Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups. J Am Heart Assoc 2022; 11:e026500. [PMID: 36172967 DOI: 10.1161/jaha.122.026500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Intracoronary imaging (ICI) has been shown to improve survival after percutaneous coronary intervention (PCI). Whether this prognostic benefit is sustained across different indications remains unclear. Methods and Results All PCI procedures performed in England and Wales between April, 2014 and March 31, 2020, were retrospectively analyzed. The association between ICI use and in-hospital major acute cardiovascular and cerebrovascular events; composite of all-cause mortality, stroke, and reinfarction and mortality was examined using multivariable logistic regression analysis for different imaging-recommended indications as set by European Association for Percutaneous Cardiovascular Interventions consensus. Of 555 398 PCI procedures, 10.8% (n=59 752) were ICI-guided. ICI use doubled between 2014 (7.8%) and 2020 (17.5%) and was highest in left main PCI (41.2%) and lowest in acute coronary syndrome (9%). Only specific European Association for Percutaneous Cardiovascular Interventions imaging-recommended indications were associated with reduced major acute cardiovascular and cerebrovascular events and mortality, including left main PCI (odds ratio [OR], 0.45 [95% CI, 0.39-0.52] and 0.41 [95% CI, 0.35-0.48], respectively), acute coronary syndrome (OR, 0.76 [95% CI, 0.70-0.82] and 0.70 [95% CI, 0.63-0.77]), and stent length >60 mm (OR, 0.75 [95% CI, 0.59-0.94] and 0.72 [95% CI, 0.54-0.95]). Stent thrombosis and renal failure were associated with lower mortality (OR, 0.69 [95% CI, 0.52-0.91]) and major acute cardiovascular and cerebrovascular events (OR, 0.77 [95% CI, 0.60-0.99]), respectively. Conclusions ICI use has more than doubled over a 7-year period at a national level but remains low, with <1 in 5 procedures performed under ICI guidance. In-hospital survival was better with ICI-guided than angiography-guided PCI, albeit only for specific indications.
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Affiliation(s)
- Mohamed O Mohamed
- Keele Cardiovascular Research Group, Centre for Prognosis Research Keele University United Kingdom.,Institute of Health Informatics University College London London United Kingdom
| | - Tim Kinnaird
- Department of Cardiology University Hospital Wales Wales
| | | | | | - Sarah Zaman
- Department of Cardiology, Westmead Hospital Sydney Australia.,Westmead Applied Research Centre University of Sydney Australia
| | - Muhammad Rashid
- Keele Cardiovascular Research Group, Centre for Prognosis Research Keele University United Kingdom
| | - Saadiq Moledina
- Keele Cardiovascular Research Group, Centre for Prognosis Research Keele University United Kingdom
| | - Peter Ludman
- Institute of Cardiovascular Sciences University of Birmingham United Kingdom
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research Keele University United Kingdom
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Matsuda H, Suzuki Y. Long-term (beyond 5 years) clinical impact of Xience everolimus-eluting stent implantation. Health Sci Rep 2021; 4:e365. [PMID: 34522790 PMCID: PMC8425589 DOI: 10.1002/hsr2.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 12/05/2022] Open
Abstract
OBJECTS We aim at examining the long-term clinical outcome after Xience everolimus-eluting stent (X-EES) implantation. BACKGROUND Long-term clinical outcomes beyond 5 years after X-EES implantation remain unclear. METHODS This retrospective study has collected data from 1184 consecutive patients, corresponding to 1463 lesions, who were treated with X-EES alone in the Nagoya Heart Center between January 2010 and December 2013. The primary endpoint was the 10-year cumulative incidence of target lesion failure (TLF), defined as cardiac death, target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR). Definite/probable stent thrombosis (ST) was evaluated as a secondary outcome. RESULTS At 10 years, the cumulative incidence of TLF was recorded to be 12.4%, whereas that of cardiac death, target vessel MI, and clinically indicated TLR was at 4.4%, 4.1%, and 7.8%, respectively. The cumulative rate of definite/probable ST was observed to remain low (0.3% at 30 days; 0.3% at 1 year; 0.6% at 5 years; and 1.1% at 10 years). In the multivariate analysis, the risk factors of TLF were insulin-treated diabetes (hazard ratio (HR), 1.93; 95% confidence interval (CI), 1.13-3.29; P = .02), left ventricular dysfunction (HR, 2.28; 95% CI, 1.43-3.62; P < .01), hemodialysis (HR, 2.22; 95% CI, 1.39-3.56; P < .01), prior percutaneous coronary intervention (HR, 1.68; 95% CI, 1.18-2.41; P < .01), peripheral vascular disease (HR, 1.70; 95% CI, 1.07-2.69; P < .01), severe calcification (HR, 2.08; 95% CI, 1.36-3.09; P < .01), and in-stent restenosis (HR, 2.93; 95% CI, 1.64-4.89; P < .01). CONCLUSIONS The incidence rates of the long-term adverse effects after X-EES implantation, such as late TLR and ST, were determined to be low in this study; however, they increased over time until 10 years after stent implantation.
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Abstract
Intravascular imaging using both intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have become important tools in the Interventional Cardiologists armamentarium. However, in some centers, intravascular imaging is not widely employed. A number of reasons for this may exist, including lack of training in the use of intravascular imaging. Co-registration with angiography may be a helpful tool for those beginning to use both IVUS and OCT in the cath lab, and may reduce the learning curve associated with its use. For experienced operators, co-registration can shorten procedure time and lessen contrast use which may be particularly important when performing complex or multivessel PCI. As a research tool, co-registration can allow for accurate comparison of interval intravascular images. In this review, we will discuss how to acquire co-registered images using both IVUS and OCT systems, and the potential advantages of this technology over non-co-registered images, and indeed angiography alone.
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Affiliation(s)
- Angela McINERNEY
- Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Javier Escaned
- Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Nieves Gonzalo
- Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain -
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Kyodo A, Watanabe M, Okamura A, Iwai S, Sakagami A, Nogi K, Kamon D, Hashimoto Y, Ueda T, Soeda T, Okura H, Saito Y. Post-Stent Optical Coherence Tomography Findings at Index Percutaneous Coronary Intervention - Characteristics Related to Subsequent Stent Thrombosis. Circ J 2021; 85:857-866. [PMID: 33504743 DOI: 10.1253/circj.cj-20-0759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).Methods and Results:Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1%, respectively; P=0.0005). The incidence of incomplete stent apposition (93.3% vs. 55.7%; P=0.0064), irregular protrusion (IP; 93.3% vs. 62.8%; P=0.0214), and thrombus (93.3% vs. 51.4%; P=0.0028) was significantly higher in the ST than reference group. The maximum median (interquartile range) IP arc was significantly larger in the ST than reference group (265° [217°-360°] vs. 128° [81.4°-212°], respectively; P<0.0001). In AMI patients, the incidence of a maximum IP arc >180° was significantly higher in the ST than reference group (100% vs. 58.3%, respectively; P=0.0265). CONCLUSIONS IP with a large arc was a significant feature on post-stent OCT in patients with ST.
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Affiliation(s)
- Atsushi Kyodo
- Department of Cardiovascular Medicine, Nara Medical University
| | - Makoto Watanabe
- Department of Cardiovascular Medicine, Nara Medical University
| | - Akihiko Okamura
- Department of Cardiovascular Medicine, Nara Medical University
| | - Saki Iwai
- Department of Cardiovascular Medicine, Nara Medical University
| | - Azusa Sakagami
- Department of Cardiovascular Medicine, Nara Medical University
| | - Kazutaka Nogi
- Department of Cardiovascular Medicine, Nara Medical University
| | - Daisuke Kamon
- Department of Cardiovascular Medicine, Nara Medical University
| | | | - Tomoya Ueda
- Department of Cardiovascular Medicine, Nara Medical University
| | - Tsunenari Soeda
- Department of Cardiovascular Medicine, Nara Medical University
| | - Hiroyuki Okura
- Department of Cardiology, Gifu University Graduate School of Medicine
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University
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The association of diabetes mellitus with neointimal formation following deployment of second-generation drug-eluting stents: an optical coherence tomographic study. Coron Artery Dis 2020; 32:105-111. [PMID: 33060524 DOI: 10.1097/mca.0000000000000964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the association of diabetes mellitus (DM) with neointimal formation after implantation of second-generation drug-eluting stent (DES) visualized by optical coherence tomography (OCT). METHODS Patients with single de novo coronary artery disease treated with second-generation DES between June 2014 and June 2017 in our department underwent OCT examination at 1-year follow-up and were enrolled in this retrospective study. The primary end point was in-stent mean neointimal thickness (MNT), and secondary end points included uncovered stent strut, minimal lumen area (MLA), neointimal burden, neointimal hyperplasia (NIH) patterns and stent thrombosis (ST) after 1 year of OCT follow-up. RESULTS A total of 68 patents with DM (DM group) and 216 patients without DM (non-DM group) were enrolled. At 1-year follow-up, the DM group compared with the non-DM group, showed: MNT [160 (85-245) μm vs. 120 (60-220) μm, P = 0.038] and neointimal burden [21.4 (8.3-30.1)% vs. 14.0 (5.7-26.1)%, P = 0.023] to be significantly increased. Concurrently, MLA [4.60 (3.53-6.06) mm vs. 5.76 (4.28-7.20) mm2, P = 0. 0.002] was significantly reduced. Interestingly, the degree of uncovered struts (7.3 ± 7.1% vs. 7.7 ± 6.7%, P = 0.704), NIH patterns (P = 0.984), and ST (7.9% vs. 7.4%, P = 0.88) were comparable between the two groups. After propensity score matching, the MNT [160 (90-240) μm vs. 110 (60-220) μm, P = 0.048] and neointimal burden [21.4 (8.3-30.1)% vs. 15.4 (5.6-26.3)%, P = 0.044] remained significantly different in the DM compared to the non-DM group. CONCLUSION DM leads to significant increase in MNT and neointimal burden even with second-generation DES, nevertheless stent strut coverage, ST and NIH characteristics remained comparable among the cohorts at 1-year.
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Clinical outcomes after percutaneous coronary intervention for early versus late and very late stent thrombosis: a systematic review and meta-analysis. J Thromb Thrombolysis 2020; 51:682-692. [PMID: 32691275 PMCID: PMC8049931 DOI: 10.1007/s11239-020-02184-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Whether the clinical outcomes of stent thrombosis (ST) are different when stratified by time of occurrence remains unclear. The objective of this study was to compare the short- and long-term clinical outcomes after percutaneous coronary intervention (PCI) for early stent thrombosis (EST) versus late stent thrombosis (LST) and very late stent thrombosis (VLST). We enrolled eligible studies searched from the main electronic databases (EMBASE, PubMed, Cochrane). The primary endpoints were in-hospital, 30-day, 1-year and long-term mortality. The secondary endpoints included recurrent stent thrombosis (RST) and target vessel/lesion revascularization (TVR/TLR) during hospitalization, at 30 days, at 1 year and at long-term follow-up. A total of 23 studies with 17,592 patients were included. Compared with mortality rates of the late and very late thrombosis (LST/VLST) group, in-hospital (P = 0.004), 30-day (P < 0.00001), 1-year (P < 0.00001) and long-term mortality rates (P = 0.04) were significantly higher in the EST group. The in-hospital TVR/TLR rates were similar between the EST group and the LST/VLST group. However, a higher trend in TVR/TLR rate at 30 days and a significantly higher TVR/TLR rate at 1 year (P = 0.002) as well as at long-term follow up (P = 0.009) were found in the EST group. EST patients also trended toward higher risk of RST in both short- and long-term follow-up than LST/VLST patients, although differences were not statistically significant. After PCI treatment, patients with EST have worse clinical outcomes in both short- and long-term follow-up than patients with LST/VLST. Further studies are warranted to determine the optimal treatment strategies for EST.
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A scoring system to predict the occurrence of very late stent thrombosis following percutaneous coronary intervention for acute coronary syndrome. Sci Rep 2020; 10:6378. [PMID: 32286484 PMCID: PMC7156476 DOI: 10.1038/s41598-020-63455-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/31/2020] [Indexed: 02/05/2023] Open
Abstract
We aimed to derive and validate an effective risk score to identify high-risk patients of very late stent thrombosis (VLST), following percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Stepwise multivariable Cox regression was used to build the risk model using data from 5,185 consecutive ACS patients treated with PCI (derivation cohort) and 2,058 patients from the external validation cohort. Eight variables were independently associated with the development of VLST: history of diabetes mellitus, previous PCI, acute myocardial infarction as admitting diagnosis, estimated glomerular filtration rate <90 ml/min/1.73 m2, three-vessel disease, number of stents per lesion, sirolimus-eluting stent, and no post-dilation. Based on the derived score, patients were classified into low- (≤7), intermediate- (8-9), and high- (≥10) risk categories. Observed VLST rates were 0.5%, 2.2%, and 8.7% and 0.45%, 2.3%, and 9.3% across the 3 risk categories in the derivation and validation cohorts, respectively. High discrimination (c-statistic = 0.80 and 0.82 in the derivation and validation cohorts, respectively) and excellent calibration were observed in both cohorts. VLST risk score, a readily useable and efficient tool to identify high-risk patients of VLST after PCI for ACS, may aid in risk-stratification and pre-emptive decision-making.
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Talanas G, Corda G, Siciliano R, Murgia A, Parodi G. Combination of transfemoral balloon-assisted tracking and the knuckle wire technique as a solution in a challenging urgent percutaneous coronary intervention. J Cardiovasc Med (Hagerstown) 2019; 20:493-494. [PMID: 30950983 DOI: 10.2459/jcm.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Giuseppe Talanas
- Clinical and Interventional Cardiology Unit, Sassari University Hospital, Sassari, Italy
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Nakamura D, Yasumura K, Nakamura H, Matsuhiro Y, Yasumoto K, Tanaka A, Matsunaga-Lee Y, Yano M, Yamato M, Egami Y, Shutta R, Sakata Y, Tanouchi J, Nishino M. Different Neoatherosclerosis Patterns in Drug-Eluting- and Bare-Metal Stent Restenosis ― Optical Coherence Tomography Study ―. Circ J 2019; 83:313-319. [DOI: 10.1253/circj.cj-18-0701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Ryu Shutta
- Division of Cardiology, Osaka Rosai Hospital
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Räber L, Mintz GS, Koskinas KC, Johnson TW, Holm NR, Onuma Y, Radu MD, Joner M, Yu B, Jia H, Meneveau N, de la Torre Hernandez JM, Escaned J, Hill J, Prati F, Colombo A, Di Mario C, Regar E, Capodanno D, Wijns W, Byrne RA, Guagliumi G. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. EUROINTERVENTION 2018; 14:656-677. [DOI: 10.4244/eijy18m06_01] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Zhao Y, Chen Z, Zhang WW, Wang S, Yang Y, Yang L. Bioabsorbable Drug-Eluting Stent Versus Bare Metal Stent in Iliac Artery Evaluated by Optical Coherence Tomography: An In Vivo Study in Porcine. Vasc Endovascular Surg 2018; 52:512-519. [PMID: 30012078 DOI: 10.1177/1538574418783528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to compare, using optical coherence tomography (OCT), the outcomes of bioabsorbable drug-eluting stent with those of bare metal stent (BMS) following implantation in porcine iliac artery. METHODS After the placement of BMS and bioabsorbable drug-eluting stents, we used OCT and digital subtraction angiography to investigate stent appositions, arterial neointima, evagination, and restenosis at 1 and 3 months. RESULTS At 1 and 3 months after stent implantation, OCT study was performed to investigate 32 stents and 21 788 struts. Thirty-three malapposed struts were found in the bioabsorbable drug-eluting stent groups and 2 were found in BMS groups. The average neointimal thickness, area, and in-stent stenosis were significantly lower in bioabsorbable drug-eluting stents than in BMS, while the frequency of malapposed struts was higher in the bioresorbable drug-eluting stent groups. Average neointimal thickness was lower in bioabsorbable drug-eluting stents than in BMS at 1 (0.19 ± 0.09 vs 0.67 ± 0.75 mm; P < .001) and 3 months (0.21 ± 0.08 vs 1.52 ± 0.28 mm; P < .001). CONCLUSION Our study suggested that bioabsorbable drug-eluting stent is more effective in decreasing arterial restenosis than BMS in animal models.
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Affiliation(s)
- Yaping Zhao
- 1 Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhong Chen
- 1 Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wayne W Zhang
- 2 Division of Vascular and Endovascular Surgery, University of Washington, Puget Sound VA Healthcare System, Seattle, WA, USA
| | - Sheng Wang
- 1 Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yaoguo Yang
- 1 Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Liao Yang
- 1 Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Konishi A, Iwasaki M, Shinke T, Otake H, Nakagawa M, Hariki H, Osue T, Inoue T, Taniguchi Y, Nishio R, Kinutani H, Hiranuma N, Kuroda M, Hirata KI, Saito S, Nakamura M, Shite J, Akasaka T. Lower on-treatment platelet reactivity during everolimus-eluting stent implantation contributes to the resolution of post-procedural intra-stent thrombus: serial OCT observation in the PRASFIT-Elective study. Heart Vessels 2018; 33:1423-1433. [PMID: 29967954 DOI: 10.1007/s00380-018-1195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/23/2018] [Indexed: 10/28/2022]
Abstract
Intra-stent thrombus (IS-Th) formed immediately after percutaneous coronary intervention (PCI) is associated with subsequent adverse coronary events. However, the impact of on-treatment platelet reactivity on IS-Th is unknown. PRASFIT-Elective is a multicenter study of PCI patients receiving prasugrel (20/3.75 mg, loading/maintenance dose) or clopidogrel (300/75 mg), with aspirin (100 mg). Among the 742 study patients, 111 were pre-specified for the OCT sub-study. Of these, 82 underwent OCT immediately after PCI to assess IS-Th and at an 8-month follow-up to evaluate the fate of the IS-Th. Lesions were considered resolved when IS-Th were detected after PCI but not on the follow-up or persistent when IS-Th were observed on both scans. The P2Y12 Reactive Unit (PRU) value was determined at the initial PCI and 4 and 48 weeks post-PCI. In 76 patients (86 lesions), we detected 230 IS-Th initially, and 196 IS-Th (85.2%) were resolved at the 8-month OCT. At PCI, but not 4 or 48 weeks after, the resolved IS-Th group had a lower PRU than the persistent IS-Th group (199 ± 101 vs. 266 ± 102, p = 0.008). Multivariate logistic regression analyses revealed that lower PRU at PCI and less calcified lesions were independent predictive factors for the resolution of IS-Th. Local lesion-related factors and lower on-treatment platelet reactivity at the time of PCI may contribute to the resolution of IS-Th after EES implantation, potentially improving clinical outcome.
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Affiliation(s)
- Akihide Konishi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masamichi Iwasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiro Shinke
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. .,Department of Cardiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Nakagawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotoshi Hariki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsuyoshi Osue
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Inoue
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryo Nishio
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroto Kinutani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noritoshi Hiranuma
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaru Kuroda
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shigeru Saito
- Division of Cardiology, Shonan Kamamura General Hospital, Kamakura, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan
| | - Junya Shite
- Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Räber L, Mintz GS, Koskinas KC, Johnson TW, Holm NR, Onuma Y, Radu MD, Joner M, Yu B, Jia H, Meneveau N, de la Torre Hernandez JM, Escaned J, Hill J, Prati F, Colombo A, di Mario C, Regar E, Capodanno D, Wijns W, Byrne RA, Guagliumi G, Alfonso F, Bhindi R, Ali Z, Carter R. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. Eur Heart J 2018; 39:3281-3300. [DOI: 10.1093/eurheartj/ehy285] [Citation(s) in RCA: 271] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/16/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Lorenz Räber
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, USA
| | | | - Thomas W Johnson
- Bristol Heart Institute, University Hospitals Bristol NHSFT, Bristol, UK
| | - Niels R Holm
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Yoshinubo Onuma
- Department of Interventional Cardiology, Cardialysis, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Maria D Radu
- The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Bo Yu
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Haibo Jia
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Jean Minjoz, Besancon, France
- EA3920, University of Burgundy Franche-Comté, Besancon, France
| | | | - Javier Escaned
- Hospital Clinico San Carlos IDISSC and Universidad Complutense, Madrid, Spain
| | - Jonathan Hill
- Department of Cardiology, King’s College Hospital, London, UK
| | - Francesco Prati
- Department of Cardiology, San Giovanni Hospital, Rome, Italy & CLI Foundation, Rome, Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele, Scientific Institute, Milan, Italy
| | - Carlo di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Evelyn Regar
- Department of Cardiovacular Surgery, Zürich University Hospita, Zürich, Switzerland
| | - Davide Capodanno
- Division of Cardiology, Cardio-Thoraco-Vascular and Transplant Department, CAST, Rodolico Hospital, AOU “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Saolta University Healthcare Group, Galway, Ireland
| | - Robert A Byrne
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Giulio Guagliumi
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Fernando Alfonso
- Department of Cardiology Hospital Universitario de la Princesa, Madrid, Spain
| | - Ravinay Bhindi
- Royal North Shore Hospital, The University of Sydney, Sydney, Australia
| | - Ziad Ali
- Columbia University Medical Center, New York, USA
| | - Rickey Carter
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
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Cuesta J, Rivero F, Bastante T, García-Guimaraes M, Antuña P, Alvarado T, Navarrete G, Benedicto A, Alfonso F. Tomografía de coherencia óptica de pacientes con trombosis del stent. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2017.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Parodi G. TOTAL evidence for drug eluting stent efficacy and safety in STEMI patients. Int J Cardiol 2017; 248:124-125. [PMID: 28724504 DOI: 10.1016/j.ijcard.2017.06.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 11/25/2022]
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19
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Nakamura D, Attizzani GF, Toma C, Sheth T, Wang W, Soud M, Aoun R, Tummala R, Leygerman M, Fares A, Mehanna E, Nishino S, Fung A, Costa MA, Bezerra HG. Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis. Circ Cardiovasc Interv 2017; 9:CIRCINTERVENTIONS.116.003785. [PMID: 27582113 DOI: 10.1161/circinterventions.116.003785] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/25/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND There are few clinical studies on the pathophysiological mechanisms of very late stent thrombosis (VLST). We report optical coherence tomography findings in patients with VLST and compare the findings between bare-metal stents (BMS) and drug-eluting stents (DES). METHODS AND RESULTS We conducted a registry of stent thrombosis at 4 North American centers with optical coherence tomography imaging programs SAFE registry (The Study of Late Stent Failure Evaluated by OCT). Images were acquired in 61 patients (42 DES and 19 BMS) presenting with definite VLST. The median duration from implantation to VLST presentation was 51.4 months in the DES and 69.9 months in the BMS group (P=0.011). Uncovered and malapposed struts were observed in 70.5% (43/61) and 62.3% (38/61) of patients, respectively, whereas neoatherosclerosis was revealed in 49.2% (30/61). Stent underexpansion was observed in 42.4% of patients. Malapposed struts and stent underexpansion were more frequently demonstrated in DES than in BMS patients, whereas neoatherosclerosis was frequently observed in BMS (40.5% in DES and 68.4% in BMS; P=0.056). The percentage of frames with neoatherosclerosis was lower in DES than in BMS (15.56% [12.24-28.57] versus, 56.41% [40.74-70.00], respectively; P<0.001). Maximum consecutive lipid neointima length was shorter in DES than in BMS (2.4 [1.2-3.6] and 5.3 [3.0-7.0] mm; P=0.011). CONCLUSIONS Optical coherence tomography imaging demonstrated that VLST in DES and BMS had a wide variety of abnormal findings, such as neoatherosclerosis, uncovered strut, and malapposed strut. Neoatherosclerosis and lipid neointima were more frequently observed and had more longitudinal extension in BMS compared with DES.
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Affiliation(s)
- Daisuke Nakamura
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Guilherme F Attizzani
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.).
| | - Catalin Toma
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Tej Sheth
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Wei Wang
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Mohamad Soud
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Reem Aoun
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Ramyashree Tummala
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Milana Leygerman
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Anas Fares
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Emile Mehanna
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Setsu Nishino
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Anthony Fung
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Marco A Costa
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
| | - Hiram G Bezerra
- From the Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH (D.N., G.F.A., W.W., M.S., R.A., R.T., M.L., A.F., E.M., S.N., M.A.C., H.G.B.); Heart and Vascular Institute, University of Pittsburgh Medical Center, PA (C.T.); McMaster University and Population Health Research Institute, Hamilton Health Sciences, Ontario, Canada (T.S.); Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson (W.W.); and Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada (A.F.)
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Cuesta J, Rivero F, Bastante T, García-Guimaraes M, Antuña P, Alvarado T, Navarrete G, Benedicto A, Alfonso F. Optical Coherence Tomography Findings in Patients With Stent Thrombosis. ACTA ACUST UNITED AC 2017; 70:1050-1058. [PMID: 28495489 DOI: 10.1016/j.rec.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/20/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES Stent thrombosis (ST) is a rare but potentially serious complication. Optical coherence tomography (OCT) provides high-resolution images and additional information to angiography in the study of this event. METHODS Prospective study of patients with ST undergoing reintervention with OCT imaging. RESULTS The study included a total of 40 consecutive patients with ST. Mean age was 69 ± 13 years and 83% were male. Early ST (≤ 30 days) was observed in 16 patients and late ST (> 30 days) in 24 patients. Stent thrombosis occurred in 17 bare-metal stents and 23 drug-eluting stents. In 34 patients (85%), adequate OCT images were obtained at the time of the ST. The predominant mechanism in early ST was stent malapposition (39%). In late ST, high frequencies of uncovered (46%) and malapposed struts (17%) were observed, especially in patients with drug-eluting stents. Furthermore, the presence of neoatherosclerosis was very high (67%) in patients with late ST. After intervention, improvements were observed in malapposition length and the amount of residual thrombus. CONCLUSIONS OCT allows identification of the underlying mechanisms potentially involved in ST. This imaging modality is helpful in guiding reintervention in these patients, which improves the area and length of malapposition, as well as the maximal residual thrombus area.
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Affiliation(s)
- Javier Cuesta
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Fernando Rivero
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Teresa Bastante
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Paula Antuña
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Teresa Alvarado
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Gonzalo Navarrete
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Amparo Benedicto
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Fernando Alfonso
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain.
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Sotomi Y, Onuma Y, Dijkstra J, Miyazaki Y, Kozuma K, Tanabe K, Popma JJ, de Winter RJ, Serruys PW, Kimura T. Fate of post-procedural malapposition of everolimus-eluting polymeric bioresorbable scaffold and everolimus-eluting cobalt chromium metallic stent in human coronary arteries: sequential assessment with optical coherence tomography in ABSORB Japan trial. Eur Heart J Cardiovasc Imaging 2017; 19:59-66. [DOI: 10.1093/ehjci/jew329] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/21/2016] [Indexed: 11/14/2022] Open
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Vallurupalli S, Kasula S, Kumar Agarwal S, Pothineni NVK, Abualsuod A, Hakeem A, Ahmed Z, Uretsky BF. A novel stent inflation protocol improves long-term outcomes compared with rapid inflation/deflation deployment method. Catheter Cardiovasc Interv 2017; 90:233-240. [DOI: 10.1002/ccd.26930] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 12/21/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Srikanth Vallurupalli
- Central Arkansas Veterans Health Care System; Little Rock Arkansas
- University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Srikanth Kasula
- University of Arkansas for Medical Sciences; Little Rock Arkansas
| | | | | | - Amjad Abualsuod
- University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Abdul Hakeem
- Central Arkansas Veterans Health Care System; Little Rock Arkansas
- University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Zubair Ahmed
- Central Arkansas Veterans Health Care System; Little Rock Arkansas
- University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Barry F. Uretsky
- Central Arkansas Veterans Health Care System; Little Rock Arkansas
- University of Arkansas for Medical Sciences; Little Rock Arkansas
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23
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De Maria GL, Banning AP. Thrombus-Containing Lesions. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Adrian P. Banning
- Oxford Heart Centre; Oxford University Hospitals, John Radcliffe Hospital; Oxford UK
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24
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Zhang YJ, Wang XZ, Fu G, Jing QM, Wang G, Jin CY, Xie LH, Cai JZ, Xu B, Han YL. Clinical and multimodality imaging results at 6 months of a bioresorbable sirolimus-eluting scaffold for patients with single de novo coronary artery lesions: the NeoVas first-in-man trial. EUROINTERVENTION 2016; 12:1279-1287. [DOI: 10.4244/eijv12i10a209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Collet C, Sotomi Y, Cavalcante R, Suwannasom P, Tenekecioglu E, Onuma Y, Serruys PW. Coronary stent thrombosis: what have we learned? J Thorac Dis 2016; 8:1398-405. [PMID: 27500366 DOI: 10.21037/jtd.2016.05.69] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Carlos Collet
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Yohei Sotomi
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Pannipa Suwannasom
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;; Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Patrick W Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London, London, UK
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Mehanna E, Attizzani GF, Nakamura D, Nishino S, Fares A, Aoun R, Costa MA, Bezerra HG. Impact of Neointimal Calcifications on Acute Stent Performance during the Treatment of In-Stent Restenosis. Arq Bras Cardiol 2016; 106:419-21. [PMID: 27305286 PMCID: PMC4914007 DOI: 10.5935/abc.20160068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022] Open
Abstract
Optical coherence tomography (OCT) has become the invasive imaging modality of
choice for coronary stent assessment due to its unmatched spatial resolution.
Neointimal calcification (NC) is a rare finding, observed in 5-10% of in-stent
restenosis (ISR) neointima. The impact of NC on percutaneous coronary
intervention of ISR is unknown. We therefore present the outcome of six unique
cases of ISR and NC in which OCT was used to evaluate the impact of NC on the
quality of stent-in-stent deployment for the treatment of ISR. This series
demonstrates for the first time the impact of NC on stent expansion, a finding
which might help guiding percutaneous coronary intervention for ISR with NC.
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Affiliation(s)
- Emile Mehanna
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Guilherme Ferragut Attizzani
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Daisuke Nakamura
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Setsu Nishino
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Anas Fares
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Reem Aoun
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Marco Aurelio Costa
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
| | - Hiram Grando Bezerra
- University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, Case Western Reserve University, USA
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Tello-Montoliu A, Rivera J, Hernández-Romero D, Silvente A, Jover E, Quintana M, Orenes-Piñero E, Hurtado J, Ferreiro JL, Marín F, Valdés M. Platelet reactivity over time in coronary artery disease patients treated with a bioabsorbable everolimus-eluting scaffold. Platelets 2016; 27:777-783. [PMID: 27257022 DOI: 10.1080/09537104.2016.1184750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Everolimus-eluting bioabsorbable scaffolds (BVSs) have exhibited similar long-term clinical outcomes compared to its everolimus-eluting metallic counterparts. However, reports from earlier studies have shown a signal for an increased rate of stent thrombosis. The aim of the current investigation is to describe the platelet reactivity profiles over time in patients treated with everolimus-eluting BVS in comparison to everolimus-eluting metallic stents. This is a pilot study in which patients on aspirin and clopidogrel with at least 1 everolimus-eluting BVS were included (n = 24). Patients with at least 1 everolimus-eluting metallic stent implanted were included as control group (n = 25). Blood samples were taken at time of discharge and at 3- and 6-month follow-up. Platelet function tests included VerifyNow (VN-P2Y12), multiplate aggregometry (MEA), and light transmission aggregometry (LTA). There was no difference in platelet reactivity at discharge, 3- and 6-month visits (unadjusted p = 0.733 and p = 0.582; p = 0.432 and p = 0.899 after adjusting for discharge value platelet reactivity0, respectively) using VN-P2Y12. Similar findings were observed with LTA. However, patients with BVS showed significantly higher platelet reactivity than patients with metallic stents at 3 and 6 months in the crude analysis (p = 0.003) and after adjusting for discharge value (p = 0.013) measured with ADP-MEA. There were no differences in platelet reactivity mediated by the T × A2 pathway between both groups. Finally, there is no statistical difference in high on-clopidogrel platelet reactivity (HPR) rate between both groups. The results of this pilot study suggest that BVS might have different platelet reactivity profiles, and warrants further investigation in dedicated clinical studies.
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Affiliation(s)
- Antonio Tello-Montoliu
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - José Rivera
- b Hematology and Oncology Department , Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Diana Hernández-Romero
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Ana Silvente
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Eva Jover
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Miriam Quintana
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Esteban Orenes-Piñero
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - José Hurtado
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - José Luis Ferreiro
- c Heart Diseases Institute, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat , Barcelona , Spain
| | - Francisco Marín
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
| | - Mariano Valdés
- a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain
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Räber L, Koskinas KC, Windecker S. Histopathological thrombus analysis in patients with stent thrombosis: what are the missing pieces in the puzzle? Eur Heart J 2016; 37:1550-2. [DOI: 10.1093/eurheartj/ehw036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Taniwaki M, Radu MD, Zaugg S, Amabile N, Garcia-Garcia HM, Yamaji K, Jørgensen E, Kelbæk H, Pilgrim T, Caussin C, Zanchin T, Veugeois A, Abildgaard U, Jüni P, Cook S, Koskinas KC, Windecker S, Räber L. Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography. Circulation 2016; 133:650-60. [PMID: 26762519 DOI: 10.1161/circulationaha.115.019071] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/05/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND The pathomechanisms underlying very late stent thrombosis (VLST) after implantation of drug-eluting stents (DES) are incompletely understood. Using optical coherence tomography, we investigated potential causes of this adverse event. METHODS AND RESULTS Between August 2010 and December 2014, 64 patients were investigated at the time point of VLST as part of an international optical coherence tomography registry. Optical coherence tomography pullbacks were performed after restoration of flow and analyzed at 0.4 mm. A total of 38 early- and 20 newer-generation drug-eluting stents were suitable for analysis. VLST occurred at a median of 4.7 years (interquartile range, 3.1-7.5 years). An underlying putative cause by optical coherence tomography was identified in 98% of cases. The most frequent findings were strut malapposition (34.5%), neoatherosclerosis (27.6%), uncovered struts (12.1%), and stent underexpansion (6.9%). Uncovered and malapposed struts were more frequent in thrombosed compared with nonthrombosed regions (ratio of percentages, 8.26; 95% confidence interval, 6.82-10.04; P<0.001 and 13.03; 95% confidence interval, 10.13-16.93; P<0.001, respectively). The maximal length of malapposed or uncovered struts (3.40 mm; 95% confidence interval, 2.55-4.25; versus 1.29 mm; 95% confidence interval, 0.81-1.77; P<0.001), but not the maximal or average axial malapposition distance, was greater in thrombosed compared with nonthrombosed segments. The associations of both uncovered and malapposed struts with thrombus were consistent among early- and newer-generation drug-eluting stents. CONCLUSIONS The leading associated findings in VLST patients in descending order were malapposition, neoatherosclerosis, uncovered struts, and stent underexpansion without differences between patients treated with early- and new-generation drug-eluting stents. The longitudinal extension of malapposed and uncovered stent was the most important correlate of thrombus formation in VLST.
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Affiliation(s)
- Masanori Taniwaki
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Maria D Radu
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Serge Zaugg
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Nicolas Amabile
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Hector M Garcia-Garcia
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Kyohei Yamaji
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Erik Jørgensen
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Henning Kelbæk
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Thomas Pilgrim
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Christophe Caussin
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Thomas Zanchin
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Aurelie Veugeois
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Ulrik Abildgaard
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Peter Jüni
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Stephane Cook
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Konstantinos C Koskinas
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Stephan Windecker
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.)
| | - Lorenz Räber
- From Department of Cardiology, Bern University Hospital, Switzerland (M.T., K.Y., T.P., T.Z., K.C.K., S.W., L.R.); Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (M.D.R., E..J.); Clinical Trials Unit, Bern University, Bern, Switzerland (S.Z.) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Medicine, University of Toronto, Canada (P.J.); Department of Cardiology, Institut Mutualiste Montsouris, Paris, France (N.A., C.C., A.V.); Interventional Cardilogy, Washington Hospital Center, Washington, DC (H.M.G.-G.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark (U.A.); and Department of Cardiology, Fribourg University and Hospital, Switzerland (S.C.).
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Souteyrand G, Amabile N, Mangin L, Chabin X, Meneveau N, Cayla G, Vanzetto G, Barnay P, Trouillet C, Rioufol G, Rangé G, Teiger E, Delaunay R, Dubreuil O, Lhermusier T, Mulliez A, Levesque S, Belle L, Caussin C, Motreff P. Mechanisms of stent thrombosis analysed by optical coherence tomography: insights from the national PESTO French registry. Eur Heart J 2016; 37:1208-16. [DOI: 10.1093/eurheartj/ehv711] [Citation(s) in RCA: 205] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 12/03/2015] [Indexed: 11/13/2022] Open
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Koskinas KC, Ughi GJ, Windecker S, Tearney GJ, Räber L. Intracoronary imaging of coronary atherosclerosis: validation for diagnosis, prognosis and treatment. Eur Heart J 2015; 37:524-35a-c. [DOI: 10.1093/eurheartj/ehv642] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/09/2015] [Indexed: 12/11/2022] Open
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Xu B, Zhang YJ, Sun ZW, Qiao SB, Chen SL, Zhang RY, Pan DR, Pang S, Zhang Q, Xu L, Yang YJ, Leon MB, Gao RL. Comparison of long-term in-stent vascular response between abluminal groove-filled biodegradable polymer sirolimus-eluting stent and durable polymer everolimus-eluting stent: 3-year OCT follow-up from the TARGET I trial. Int J Cardiovasc Imaging 2015. [DOI: 10.1007/s10554-015-0721-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vallurupalli S, Bahia A, Ruiz-Rodriguez E, Ahmed Z, Hakeem A, Uretsky BF. Optimization of stent implantation using a high pressure inflation protocol. Catheter Cardiovasc Interv 2015; 87:65-72. [DOI: 10.1002/ccd.26095] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 04/24/2015] [Accepted: 06/14/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Srikanth Vallurupalli
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Amit Bahia
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Ernesto Ruiz-Rodriguez
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
| | - Zubair Ahmed
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
- Central Arkansas Veterans Healthcare System; Little Rock Arkansas
| | - Abdul Hakeem
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
- Central Arkansas Veterans Healthcare System; Little Rock Arkansas
| | - Barry F. Uretsky
- Division of Cardiology; University of Arkansas for Medical Sciences; Little Rock Arkansas
- Central Arkansas Veterans Healthcare System; Little Rock Arkansas
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Mattesini A, Bellandi B, Valente S, Parodi G. Diagnosis and Evaluation of Stent Thrombosis with Optical Coherence Tomography. Interv Cardiol Clin 2015; 4:295-307. [PMID: 28581946 DOI: 10.1016/j.iccl.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Stent thrombosis (ST) is a rare complication of percutaneous coronary interventions (PCI), especially with drug-eluting stents. ST presents as acute myocardial infarction requiring emergent repeat PCI; optimal reperfusion occurs in two-thirds of patients. As a result, ST has been associated with a high mortality rate and a high rate of recurrent thrombosis. We discuss the use of optical coherence tomography (OCT) for the diagnosis and evaluation of ST. OCT-guided ST management seems a feasible, safe, and appropriate approach. Intracoronary assesses the efficacy of coronary thrombus removal procedures and detects the prevalent stent-related factor that caused ST.
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Affiliation(s)
- Alessio Mattesini
- Department of Cardiology, Careggi Hospital, Largo Brambilla n 3, Florence 50100, Italy
| | - Benedetta Bellandi
- Department of Cardiology, Careggi Hospital, Largo Brambilla n 3, Florence 50100, Italy
| | - Serafina Valente
- Department of Cardiology, Careggi Hospital, Largo Brambilla n 3, Florence 50100, Italy
| | - Guido Parodi
- Department of Cardiology, Careggi Hospital, Largo Brambilla n 3, Florence 50100, Italy.
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Zhang YJ, Pan DR, Pang S, Wu W, Xu B. Biodegradable or biocompatible polymer drug-eluting stent: a Gordian knot. EUROINTERVENTION 2015. [DOI: 10.4244/eijv11i3a48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kawamoto H, Latib A, Ruparelia N, Miyazaki T, Sticchi A, Naganuma T, Sato K, Figini F, Chieffo A, Carlino M, Montorfano M, Colombo A. Clinical outcomes following bioresorbable scaffold implantation for bifurcation lesions: Overall outcomes and comparison between provisional and planned double stenting strategy. Catheter Cardiovasc Interv 2015; 86:644-52. [DOI: 10.1002/ccd.26045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/16/2015] [Accepted: 05/07/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Hiroyoshi Kawamoto
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit, New Tokyo Hospital; Chiba Japan
| | - Azeem Latib
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Neil Ruparelia
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
- Imperial College; London United Kingdom
| | - Tadashi Miyazaki
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Alessandro Sticchi
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Toru Naganuma
- Interventional Cardiology Unit, New Tokyo Hospital; Chiba Japan
| | | | - Filippo Figini
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Mauro Carlino
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
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Nakabayashi K, Okada H, Asano R, Nakazawa N, Nomura H, Oka T. The usefulness of a perfusion balloon in a case of late stent thrombosis that caused simultaneous double vessel occlusion. Cardiovasc Interv Ther 2015; 31:226-30. [PMID: 25971225 DOI: 10.1007/s12928-015-0335-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/02/2015] [Indexed: 11/26/2022]
Abstract
Simultaneous stent thrombosis in different coronary arteries requires rapid management. A 70-year-old man experienced simultaneous stent thrombosis at the left anterior descending and circumflex arteries. We used a perfusion balloon to prevent thrombus production at the left anterior descending artery, and completed percutaneous coronary intervention at the left circumflex artery in 10 min. The perfusion balloon was dilated during the procedure. In both vessels, Thrombolysis in myocardial infarction flow grade 3 was achieved after balloon deflation. Thus, use of a perfusion balloon for simultaneous double vessel occlusion helped avoid the need for redundant stent placement and shortened the procedure time.
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Affiliation(s)
- Keisuke Nakabayashi
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan.
| | - Hisayuki Okada
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan
| | - Ryotaro Asano
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan
| | - Naomi Nakazawa
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan
| | - Hidekimi Nomura
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan
| | - Toshiaki Oka
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City, Shizuoka, 430-8558, Japan
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38
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Walters DL, Christopher Raffel O, Jang IK. Are the findings of optical coherence tomography sufficient for the evaluation of the safety and efficacy of the next generation of drug eluting stents? Int J Cardiol 2015; 179:127-8. [PMID: 25464431 DOI: 10.1016/j.ijcard.2014.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 10/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Darren L Walters
- The Prince Charles Hospital, Rode Rd, Brisbane, Australia; The University of Queensland, St Lucia, Brisbane, Australia.
| | - O Christopher Raffel
- The Prince Charles Hospital, Rode Rd, Brisbane, Australia; The University of Queensland, St Lucia, Brisbane, Australia
| | - Ik-Kyung Jang
- Massachusetts General Hospital, 55 Fruit St, Boston, United States; Harvard Medical School Boston, United States
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39
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De Maria GL, Sarwar R, Banning AP. Eculizumab treatment for paroxysmal nocturnal haemoglobinuria in a patient with recurrent simultaneous multivessel coronary stent thrombosis. Oxf Med Case Reports 2015; 2015:167-9. [PMID: 25988068 PMCID: PMC4369974 DOI: 10.1093/omcr/omu063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/17/2014] [Accepted: 12/20/2014] [Indexed: 11/13/2022] Open
Abstract
We describe a case of recurrent multivessel coronary stent thrombosis in the absence of the typical hallmarks of this phenomenon: (i) discontinuation or poor compliance with double antiplatelet therapy; (ii) stent malapposition and (iii) stent underexpansion. In this case, the recurrence of stent thrombosis was indeed manifestation of a more complex underlying disease, and eventually allowed the clinicians to come to the final diagnosis of paroxysmal nocturnal haemoglobinuria.
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Affiliation(s)
| | | | - Adrian P. Banning
- Correspondence address. The John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. Tel: 08165 228934; Fax: 01865 220585; E-mail:
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40
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Parodi G, Bellandi B, Antoniucci D. Switching from ticagrelor to prasugrel: a warning. Int J Cardiol 2014; 176:1089-90. [PMID: 25125013 DOI: 10.1016/j.ijcard.2014.07.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/26/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Guido Parodi
- Department of Heart and Vessels, Careggi University Hospital, Florence, Italy.
| | - Benedetta Bellandi
- Department of Heart and Vessels, Careggi University Hospital, Florence, Italy
| | - David Antoniucci
- Department of Heart and Vessels, Careggi University Hospital, Florence, Italy
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Development of 3D IVOCT Imaging and Co-Registration of IVOCT and Angiography in the Catheterization Laboratory. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9290-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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42
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Di Vito L, Prati F. OCT Guidance to Improve Clinical Outcome of Coronary Interventions: What Have We Learnt? CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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