Usefulness of Intracoronary Brachytherapy for Patients With Resistant Drug-Eluting Stent Restenosis

2017 ◽  
Vol 120 (3) ◽  
pp. 369-373 ◽  
Author(s):  
Fernanda M. Mangione ◽  
Tannas Jatene ◽  
Roza Badr Eslam ◽  
Brian A. Bergmark ◽  
Jacob R. Gallagher ◽  
...  
Keyword(s):  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Intracoronary Brachytherapy

scholarly journals TCTAP A-030 Drug Coated Balloon Versus Drug-eluting Stent for In-stent Restenosis After Drug-eluting Stent Implantation: A Meta-analysis

2021 ◽  
Vol 77 (14) ◽  
pp. S19
Author(s):  
Hendy Bhaskara Perdana Putra ◽  
Quri Meihaerani Savitri ◽  
Wally Wahyu Mukhammad ◽  
Atiyatum Billah ◽  
Alan Dharmasaputra ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Meta Analysis ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Drug Coated Balloon ◽  
In Stent Restenosis

scholarly journals Polarization-sensitive OFDI findings of vascular tissue response following drug-eluting stent implantation in patients with coronary artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Otsuka ◽  
M Villiger ◽  
L.J.C Van Zandvoort ◽  
T Neleman ◽  
A Karanasos ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Vascular Tissue ◽  
Clinical Decision ◽  
Estimating Equation ◽  
Tissue Response ◽  
Drug Eluting Stent ◽  
Funding Source ◽  
National Budget ◽  
Stent Restenosis ◽  
Drug Eluting

Abstract   Intravascular polarimetry (IVP) with polarization-sensitive (PS-) optical frequency domain imaging (OFDI) measures polarization properties of the coronary arterial wall in parallel with the conventional OFDI images (Figure 1A). Tissues rich in collagen and smooth muscle cells (SMCs) appear birefringent, while the presence of lipid and macrophages causes depolarization. Because drug-eluting stents (DES) are designed to prevent SMC proliferation and collagen deposition, we hypothesized that neointimal tissue would exhibit low birefringence. The accumulation of lipid-laden macrophages characteristic of neoatherosclerosis should result in notable depolarization. Methods This study included 19 DES imaged with PS-OFDI in 13 patients (median follow-up period of 1.5 years). Coronary segments stented >90 days were analyzed every 1 mm. We analyzed polarization properties of the neointima in a total of 455 frames, and in additional 97 frames of native atherosclerosis remote from the stented segments. Neointima, delineated by the lumen and the inner boundary of the stent, was manually segmented in the intensity images using MATLAB. The median birefringence in all areas of the segmented neointima featuring a depolarization of ≤0.2 and the median depolarization across the entire neointima were computed for each frame after masking the guidewire shadow. Frames presenting intensity features of macrophages, lipid or calcifications extending to at least one adjacent frame were classified as neoatherosclerosis (n=112), and otherwise as normal neointima (n=343). For comparison with neoatherosclerosis, polarization properties of native atherosclerosis (n=97) were measured. We also categorized all frames of a stented segment according to the presence of in-stent restenosis (ISR) and/or stent thrombosis (ST) (204 frames from 5 patients). A generalized linear model using a generalized estimating equation or one-way ANOVA was used for statistical analysis. Results The major findings of the present study are: 1) neoatherosclerosis exhibited lower birefringence than native atherosclerosis (p<0.001, Figure-1B); 2) depolarization was positively associated with neoatherosclerosis (β=0.86, p<0.001) and ISR/ST (β=0.72, p=0.002), while birefringence was not (Figure 1C); 3) birefringence was positively correlated with the duration after DES implantation (β=5.22×10–3, p<0.001, Figure 1D). For the detection of neointimas within stents with ISR, the best cut-off value for depolarization was 0.033 with a sensitivity of 77% and a specificity of 57% (AUC=0.72). For comparison, using only conventional OFDI parameters to detect stents with ISR, the AUC were 0.52 for calcium area, 0.62 for lipid arc, and 0.63 for macrophage accumulations. Conclusions This study suggests that IVP provides quantitative assessment of vascular healing after DES implantation and may help clinical decision making in patients at high risk of stent failure. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported by the National Institutes of Health.

scholarly journals Long-Term Efficacy and Safety of Paclitaxel-Eluting Balloon for the Treatment of Drug-Eluting Stent Restenosis

2015 ◽  
Vol 8 (7) ◽  
pp. 877-884 ◽  
Author(s):  
Sebastian Kufner ◽  
Salvatore Cassese ◽  
Marco Valeskini ◽  
Franz-Josef Neumann ◽  
Stefanie Schulz-Schüpke ◽  
...  
Keyword(s):  
Drug Eluting Stent ◽  
Efficacy And Safety ◽  
Term Efficacy ◽  
Stent Restenosis ◽  
Drug Eluting

scholarly journals Late Restenosis After Paclitaxel-Coated Balloon Angioplasty Occurs in Patients With Drug-Eluting Stent Restenosis

2015 ◽  
Vol 66 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Seiji Habara ◽  
Kazushige Kadota ◽  
Takenobu Shimada ◽  
Masanobu Ohya ◽  
Hidewo Amano ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Late Restenosis

The effect of REDV/TiO2 coating coronary stents on in-stent restenosis and re-endothelialization

2016 ◽  
Vol 31 (6) ◽  
pp. 911-922 ◽  
Author(s):  
Xiangshan Xu ◽  
Lijie Wang ◽  
Guofeng Wang ◽  
Yuanzhe Jin
Keyword(s):  
Metal Ion ◽  
316L Stainless Steel ◽  
Ceramic Coating ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

The coronary artery stent has been widely used in clinic. In-stent restenosis was mainly caused by the excessive proliferation of smooth muscle cell and the inflammation due to the metal ion released from stent scaffold of the drug-eluting stent. Thus, to reduce the in-stent restenosis and promote the vascular endothelialization have become a hot research point in this area. In this paper, a nano-TiO2 ceramic coating was deposited on 316L stainless steel to reduce the metal ion release and to inhibit the inflammation reaction. An endothelia cell selective adhesion peptide Arg-Glu-Asp-Val (REDV) coating was prepared on the ceramic coating by a polydopamine technology to promote the endothelialization. The corrosion test indicated that nano-TiO2 ceramic film could effectively decrease the nickel ion released from 316L stainless steel. REDV/TiO2 coating could promote the endothelial cell adhesion and proliferation, meanwhile REDV/TiO2 coating could also increase the nitric oxide concentration. Bare metal stent, TiO2-coated stent and REDV/TiO2-coated stent were implanted in the iliac arteries of rabbit model. In-stent restenosis and re-endothelialization were evaluated at 28 days post-implantation of the stents. The results showed that REDV/TiO2-coated stents could effectively reduce in-stent restenosis and promote re-endothelialization in comparison with TiO2-coated drug-eluting stent and bare metal stent. These results suggest that REDV/TiO2-coated drug-eluting stent maybe a good choice of the application for coronary artery disease.

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