Mobilization of progenitor cells and vessel healing after implantation of SYNERGY in acute coronary syndrome

AbstractThis study was aimed to compare the vascular healing process of a SYNERGY stent with that of a PROMUS PREMIER stent in patients with acute coronary syndrome (ACS). In 71 patients with ACS, undergoing coronary stent implantation using the SYNERGY stent (n = 52) or PROMUS PREMIER stent (n = 19), we measured circulating CD34+/CD133+/CD45null cells and CD34+/KDR+ cells and observed vascular healing at the stented sites using optical coherence tomography (OCT) and coronary angioscopy. On the day 7, circulating CD34+/CD133+/CD45null cells increased in SYNERGY group (P < 0.0001), while it did not change in PROMUS group. The CD34+/KDR+ cells also increased in SYNERGY group (P < 0.0001) but less significantly in the PROMUS group (P < 0.05). The OCT-based neointimal thickness (P < 0.0005) and neointimal coverage rate (P < 0.05) at 12 months were greater in SYNERGY group, compared with PROMUS group. The coronary angioscopy-based neointimal coverage grade at 12 months was also greater in SYNERGY group (P < 0.001). In overall patients, the change in CD34+/KDR+ cells on the day 7 correlated with the OCT-based neointimal thickness at 12 months (R = 0.288, P < 0.05). SYNERGY stent seems to have potential advantages over PROMUS PREMIER stent for ACS patients in terms of vascular healing process at the stented sites.

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Mobilization of Progenitor Cells and Vessel Healing After Implantation of Synergytm in Acute Coronary Syndrome

10.21203/rs.3.rs-279324/v1 ◽

2021 ◽

Author(s):

Masashi Sakuma ◽

Setsu Nishino ◽

Takahisa Nasuno ◽

Michiaki Tokura ◽

Ryoichi Sohma ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Acute Coronary Syndrome ◽

Progenitor Cells ◽

Stent Implantation ◽

Healing Process ◽

Coronary Syndrome ◽

Neointimal Thickness ◽

Coronary Stent Implantation ◽

Coronary Angioscopy ◽

Neointimal Coverage

Abstract This study was aimed to compare the vascular healing process of a SYNERGYTM stent with that of a PROMUS PREMIERTM stent in patients with acute coronary syndrome (ACS).　In 71 patients with ACS, undergoing coronary stent implantation using the SYNERGYTM stent (n=52) or PROMUS PREMIERTM stent (n=19), we measured circulating CD34+/CD133+/CD45null cells and CD34+/KDR+ cells and observed vascular healing at the stented sites using optical coherence tomography (OCT) and coronary angioscopy. On the day 7, circulating CD34+/CD133+/CD45null cells increased in SYNERGY group (P<0.0001), while it did not change in PROMUS group. The CD34+/KDR+ cells also increased in SYNERGY group (P<0.0001) but less significantly in the PROMUS group (P<0.05). The OCT-based neointimal thickness (P<0.0005) and neointimal coverage rate (P<0.05) at 12 months were greater in SYNERGY group, compared with PROMUS group. The coronary angioscopy-based neointimal coverage grade at 12 months was also greater in SYNERGY group (P<0.001). In overall patients, the change in CD34+/KDR+ cells on the day 7 correlated with the OCT-based neointimal thickness at 12 months (R=0.288, P<0.05).　SYNERGYTM stent seems to have potential advantages over PROMUS PREMIERTM stent for ACS patients in terms of vascular healing process at the stented sites.

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Insights into stent implantation for coronary artery lesions caused by Kawasaki disease

Cardiology in the Young ◽

10.1017/s104795112000133x ◽

2020 ◽

Vol 30 (7) ◽

pp. 911-918

Author(s):

Etsuko Tsuda

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Kawasaki Disease ◽

Adverse Effects ◽

Stent Implantation ◽

Long Term Results ◽

Coronary Artery Lesions ◽

Coronary Syndrome ◽

Coronary Stent Implantation

AbstractFifty years have passed since the first report of Kawasaki disease in 1967, and the prevalence of acute coronary syndrome in Kawasaki disease patients with coronary artery lesions exceeding 40 years old has increased. Primary coronary stent implantation is currently an acceptable method in ischaemic coronary heart disease in adults. However, it is unknown whether the stent implantation is effective or not in this population. As the clue to answer this question, I reviewed the references on Kawasaki disease patients who underwent the stent implantations between 1997 and 2019. Thirty-three patients underwent stent implantations for 34 coronary arteries. Adverse effects in the late period were found in 19 (68%) of 28 vessels with follow-up angiograms. There were complete occlusion 9, restenosis 8, and migration 2. A new aneurysm formation was found in 7 (37%) among the 19 vessels, and 6 (86%) of the 7 vessels were drug-eluting stent and 5 were found after the procedure for chronic total occlusion. The adverse effects free-rate at 1 year and 3 years were 57 and 25%, respectively. At present, the usefulness of stent implantation in the long-term results was scarce. Even if primary percutaneous coronary intervention without a stent implantation is performed for acute coronary syndrome, it can be expected to maintain the patency of the culprit lesion for several years. It is better to avoid a stent implantation as long as possible in this population. Knowing the long-term efficacy and complications of stent implantations is important for deciding the procedure.

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Different vascular healing process between bioabsorbable polymer-coated everolimus-eluting stents versus bioresorbable vascular scaffolds via optical coherence tomography and coronary angioscopy (the ENHANCE study: ENdothelial Healing Assessment with Novel Coronary tEchnology)

Heart and Vessels ◽

10.1007/s00380-019-01516-9 ◽

2019 ◽

Vol 35 (4) ◽

pp. 463-473 ◽

Cited By ~ 1

Author(s):

Wan Azman Wan Ahmad ◽

Takaharu Nakayoshi ◽

Ahmad Syadi Mahmood Zuhdi ◽

Muhammad Dzafir Ismail ◽

Imran Zainal Abidin ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Healing Process ◽

Coronary Vessels ◽

Optical Coherence ◽

Bioabsorbable Polymer ◽

Neointimal Thickness ◽

Yellow Plaque ◽

Coronary Angioscopy ◽

Vascular Scaffolds ◽

Bioresorbable Vascular Scaffolds

Abstract Recent clinical trials have raised concerns about the safety and efficacy of ABSORB™ bioresorbable vascular scaffolds (BVS). The difference in the vascular healing process between SYNERGY™ bioabsorbable polymer-coated everolimus-eluting stents (BP-EES) and BVS remains unclear. The aim of the ENHANCE study was to compare vascular healing on BP-EES versus BVS by optical coherence tomography (OCT) and coronary angioscopy (CAS) at 4- and 12-month follow-ups. This is a prospective, non-randomized, single center clinical trial. Thirteen eligible patients with multivessel disease were enrolled. BP-EES and BVS were simultaneously implanted in the same patients, but in different coronary vessels. Imaging follow-up with both OCT and CAS was completed in 11 patients at 12 months. Neointimal coverage rates were similar between the two groups based on OCT measurements. The neointimal thickness of BP-EES was significantly thicker at the 12th month than at the 4th month, whereas the neointimal thickness of BVS did not change between the measurements taken at the 4th and 12th month. Existence of intra-stent thrombus was significantly higher in the BVS group, compared to the BP-EES group. On the other hand, CAS revealed that red-thrombi and yellow-plaque were more frequently observed in BVS at 4 months and up to 12-month follow-ups than in BP-EES. These findings suggested that the evidence of instability remained up to 12 months in the vascular healing with BVS, compared to that with BP-EES. Vascular healing of the stented wall was recognized at the very early phase after BP-EES implantation. However, vascular healing with BVS was still incomplete after 12 months.

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Aggressive Antiplatelet Therapy Before Coronary Stent Implantation in Acute Coronary Syndrome with Essential Thrombocythemia

Angiology ◽

10.1177/000331970305400414 ◽

2003 ◽

Vol 54 (4) ◽

pp. 485-490 ◽

Cited By ~ 5

Author(s):

Mitsunori Fujimura ◽

Masashi Akaike ◽

Midori Kato ◽

Nobuyuki Takamori ◽

Masahiro Abe ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Antiplatelet Therapy ◽

Essential Thrombocythemia ◽

Stent Implantation ◽

Coronary Stent ◽

Coronary Syndrome ◽

Coronary Stent Implantation

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Stent implantation and vascular healing of a spontaneous coronary artery dissection assessed by optical coherence tomography in a patient with acute coronary syndrome

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2017.08.017 ◽

2018 ◽

Vol 19 (3) ◽

pp. 376-379

Author(s):

Kirstine Nørregaard Hansen ◽

Lisbeth Antonsen ◽

Lisette Okkels Jensen

Keyword(s):

Optical Coherence Tomography ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Stent Implantation ◽

Artery Dissection ◽

Optical Coherence ◽

Spontaneous Coronary Artery Dissection ◽

Coronary Artery Dissection ◽

Coronary Syndrome

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Optical coherence tomography follow-up 18 months after titanium-nitride-oxide-coated versus everolimus-eluting stent implantation in patients with acute coronary syndrome

Acta Radiologica ◽

10.1177/0284185116683573 ◽

2016 ◽

Vol 58 (9) ◽

pp. 1077-1084

Author(s):

Pasi Karjalainen ◽

Tuomas Paana ◽

Antti Ylitalo ◽

Jussi Sia ◽

Wail Nammas

Keyword(s):

Optical Coherence Tomography ◽

Acute Coronary Syndrome ◽

Titanium Nitride ◽

Cross Sections ◽

Coronary Syndrome ◽

Stent Strut ◽

Neointimal Coverage ◽

Nitride Oxide ◽

Level Analysis

Background Inadequate neointimal coverage of stent struts is associated with late stent thrombosis. Purpose To demonstrate the extent of neointimal coverage and strut malapposition in titanium-nitride-oxide-coated bioactive stents (BAS) versus everolimus-eluting stents (EES) by optical coherence tomography (OCT) performed at 18-month follow-up. Material and Methods In the BASE-ACS trial, 827 patients presenting with acute coronary syndrome were randomized to receive either BAS or EES. Forty patients (20 BAS, 20 EES) underwent OCT at 18-month follow-up for evaluation of stent strut coverage, malapposition, and neointimal hyperplasia (NIH). Primary endpoint was binary stent strut coverage (ratio of covered struts to all analyzed struts multiplied by 100). Co-primary endpoint was the percentage of malapposed struts. Results We analyzed 3465 struts in 330 cross-sections of BAS and 3327 struts in 316 cross-sections of EES. Binary stent strut coverage, based on strut-level analysis, was higher with BAS versus EES (99.5% versus 94.2%, respectively; P < 0.001), the strut-level percentage of malapposed struts was lower with BAS (0.6% versus 2.5%, respectively; P < 0.001). Yet, the mean NIH thickness was greater with BAS (237 ± 125 versus 108 ± 62 µm, respectively; P < 0.001). Conclusion In the current post-hoc analysis with OCT performed at 18 months, binary strut coverage, based on strut-level analysis, was higher with BAS versus EES; strut-level malapposed struts were fewer with BAS; yet, BAS induced thicker NIH.

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