scholarly journals ARTERIAL WALL MECHANICS AND CLINICAL IMPLICATIONS AFTER CORONARY STENTING: COMPARISONS OF THREE STENT DESIGNS

2012 ◽  
Vol 04 (02) ◽  
pp. 1250013 ◽  
Author(s):  
LINXIA GU ◽  
SHIJIA ZHAO ◽  
STACEY R. FROEMMING
Keyword(s):  
Stress Distributions ◽  
Cobalt Chromium ◽  
Stress Concentrations ◽  
Stent Deployment ◽  
Stress Variation ◽  
Stent Restenosis ◽  
Arterial Wall Mechanics ◽  
The Impact ◽  
The Relationship ◽  
In Stent Restenosis

The goal of this work is to quantitatively assess the relationship between the reported restenosis rates and stent induced arterial stress or strain parameters through finite element method. The impact of three stent designs (Palmaz–Schatz stent, Express stent, and Multilink Vision stent) on the arterial stress distributions were characterized. The influences of initial stent deployment location, stent-tissue friction, and plaque properties on the arterial stresses were also investigated. Higher arterial stresses were observed at the proximal end of the plaque. The Multilink–Vision stent induced lesser stress concentrations due to the high stiffness of the Cobalt Chromium material and thinner strut thickness. The stent-induced arterial stress concentrations were positively correlated with the reported in-stent restenosis rates, with a correlation coefficient of 0.992. Stent deployment initiated at the center of the lumen led to less arterial stress variation, while deployment closer to the thinner edge of the plaque causes higher arterial stresses. The friction between the stent and tissue was found to contribute to larger stress alternations for the plaque only. Increased plaque stiffness resulted in a reduced arterial stress concentration and clinical restenosis rate. Results presented herein suggested that arterial stresses serve as a comprehensive index factor to predict the occurrence of in-stent restenosis, which will facilitate the new stent design and surgical planning.

scholarly journals Mehran in-stent restenosis classification adapted for coronary bifurcations: the impact on 4-year follow-up from randomized clinical studies POLBOS I and II

2018 ◽  
Vol 14 (3) ◽  
pp. 299-303 ◽  
Author(s):  
Jacek Bil ◽  
Robert J. Gil ◽  
Adam Kern ◽  
Luis A. Inigo-Garcia ◽  
Radosław Formuszewicz ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Stent Restenosis ◽  
The Impact ◽  
In Stent Restenosis

scholarly journals Relation of Nickel Allergy with in-Stent Restenosis in Patients Treated with Cobalt Chromium Stents

2012 ◽  
Vol 24 (4) ◽  
pp. 426 ◽  
Author(s):  
Cihangir Aliağaoğlu ◽  
Hakan Turan ◽  
İsmail Erden ◽  
Hülya Albayrak ◽  
Hakan Özhan ◽  
...  
Keyword(s):  
Cobalt Chromium ◽  
Nickel Allergy ◽  
Stent Restenosis ◽  
In Stent Restenosis

Abstract 12908: Effects of Metabolic Syndrome on In-Stent Restenosis After PCI: Obesity Paradox and Sex-Associated Differences

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kenji Sakamoto ◽  
Naohiro Komura ◽  
Kenichi Tsujita ◽  
Kenshi Yamanaga ◽  
Noriaki Tabata ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Obesity Paradox ◽  
Target Lesion ◽  
Positive Influence ◽  
Female Patients ◽  
Stent Restenosis ◽  
The Impact ◽  
In Stent Restenosis

Background: The impact of metabolic syndrome (MetS) on the efficacy of PCI remains controversial. Hypothesis: This controversy may be due in part to a positive influence of obesity (the “obesity paradox”) among the factors included in the definition of MetS. Fat distribution also varies by sex, possibly confounding the impact of obesity. Methods: To elucidate the possible effects of obesity in MetS patients on in-stent restenosis (ISR) or target lesion revascularization (TLR), 546 patients treated with coronary stents (BMS or DES) were stratified according to the presence of MetS with or without obesity, using NCEP-ATP III guidelines. Waist circumference or BMI (in patients without waist circumference data) was used for diagnosis of obesity. Follow-up angiography was scheduled 8 to 9 months after PCI to obtain ISR, which was defined as %diameter stenosis (%DS)>50%. Results: Mean age of the subjects was 70.5±9.8 years, and 32.1% were female. By standard criteria, 286 patients (52.4%) were diagnosed as MetS, and 320 patients (58.6%) met criteria for obesity. Among MetS patients, 61 patients (21.3% of MetS patients) were categorized as non-obesity. At 8 to 9 months follow-up, % DS, ISR rates, and TLR rates had trends to be higher in MetS than no-MetS (ISR; 26.6% in MetS, 20.0% in non-MetS, p=0.085). These parameters showed no difference between obesity and non-obesity (ISR; 23.8% in obesity, 23.0% in non- obesity, p=0.918, TLR; 14.1% in obesity, 15.0% in non-obesity, p=0.805). In patients with MetS (Figure), however, the ratio of %DS and ISR were significantly greater in the absence of obesity in female patients, whereas no difference was observed in male patients. In multivariate analysis, non-obesity was an independent predictor for ISR or TLR in female patients with MetS. Conclusions: Overall, obesity was not related to ISR or TLR after PCI. In female MetS patients, however, comorbidity of obesity appeared to be paradoxically protective.

scholarly journals IMPACT OF ANGIOGRAPHIC PATTERNS OF IN-STENT RESTENOSIS ON LONG-TERM CLINICAL OUTCOMES IN PATIENTS TREATED WITH COBALT-CHROMIUM EVEROLIMUS-ELUTING STENT

2020 ◽  
Vol 75 (11) ◽  
pp. 1368
Author(s):  
Takashi Hiromasa ◽  
Shoichi Kuramitsu ◽  
Seiichi Hiramori ◽  
Kyohei Yamaji ◽  
Takenori Domei ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cobalt Chromium ◽  
Stent Restenosis ◽  
In Stent Restenosis

BALLOON-EXPANDABLE STENTS EXPANSION IN TAPERED VESSELS AND THEIR INTERACTIONS

2014 ◽  
Vol 14 (06) ◽  
pp. 1440013 ◽  
Author(s):  
XIANG SHEN ◽  
ZHONG-MIN XIE ◽  
YANG-YANG SUN ◽  
BO-BO WU
Keyword(s):  
Stent Design ◽  
Expansion Process ◽  
Stent Deployment ◽  
Stent Restenosis ◽  
Clinical Observations ◽  
Tissue Stresses ◽  
Maximum Stresses ◽  
In Stent Restenosis ◽  
Tv Model

In-stent restenosis (ISR) after stent implantation, especially in tapered vessels, remains an obstacle in the long-term benefits of stenting. In the present study, a finite element method (FEM) was employed to investigate the expansion process of balloon-expandable stents in tapered vessels (the TV model) and their interactions. For comparison, a numerical model of the same stent deployment in a straight vessel was also investigated. Results showed that in the TV model, the peak tissue stresses took place at the distal end of the tapered vessel. The node displacements of the stent's proximal and distal ends remained consistent before the stent contacted the tapered vessel, while the proximal end was larger than the distal end after the stent contacted the tapered vessel. The regions of maximum stresses in the stent after expansion were concentrated in the corners of the diamond cells of the stent's proximal end. The investigation provided some interpretations of the clinical observations in tapered vessels and also provided stent design proposals for tapered vessels. The FEM quantified the mechanical properties of stents in tapered vessels, and can help clinicians select appropriate stents, assist designers in pretests and create new stents made especially for tapered vessels.

scholarly journals THREE-YEAR CLINICAL OUTCOMES OF THE XIENCE/PROMUS COBALT-CHROMIUM EVEROLIMUS-ELUTING STENT IN PATIENTS TREATED WITH IN-STENT RESTENOSIS

2017 ◽  
Vol 69 (11) ◽  
pp. 1392
Author(s):  
Takashi Hiromasa ◽  
Shoichi Kuramitsu ◽  
Takashi Morinaga ◽  
Yohei Kobayashi ◽  
Hiroyuki Jinnouchi ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cobalt Chromium ◽  
Stent Restenosis ◽  
In Stent Restenosis

scholarly journals PHYSICAL ACTIVITY AND TRACE ELEMENT METABOLISM

2020 ◽  
Vol 21 (2) ◽  
pp. 3-12
Author(s):  
A.A. Skalny ◽  
Keyword(s):  
Physical Activity ◽  
Trace Elements ◽  
Trace Element ◽  
The Body ◽  
Cobalt Chromium ◽  
Essential Trace Elements ◽  
Trace Element Metabolism ◽  
The Impact ◽  
The Relationship ◽  
Insight Into

Currently, there is no doubt about the prevailing influence of the level of physical activity of an individual on the functional state of the body. However, the available literature data on the impact of physical stress on the body's supply of trace elements and their distribution in tissues are largely contradictory. This review of available literature data provides an insight into the relationship between physical activity and microelement homeostasis. The influence of human physical activity on the exchange of toxic (lead, cadmium, Nickel, etc.) and essential trace elements, such as iron, selenium, copper, cobalt, chromium, and zinc is reviewed. Based on the analyzed works, it is concluded that in order to correct the metabolic and microelement status of a person during physical activity, the most reasonable and necessary is the modulation of homeostasis of zinc and selenium.

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