scholarly journals Anti-Inflammatory Effects of Arsenic Trioxide Eluting Stents in a Porcine Coronary Model

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Li Shen ◽  
Feirong Gong ◽  
Wenjie Tian ◽  
Weiming Li ◽  
Feng Zhang ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Arsenic Trioxide ◽  
Function Analysis ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Neointimal Formation ◽  
Inflammatory Reactions ◽  
Significant Difference ◽  
Anti Inflammatory

Previous research from our group has demonstrated arsenic trioxide eluting stents significantly reduced neointimal area and thickness compared with bare metal stents. In the present study, the anti-inflammatory effects of arsenic trioxidein vitroand arsenic trioxide eluting stents in a porcine coronary model have been explored. Sixty-five pigs underwent placement of 139 oversized stents in the coronary arteries with histologic analysis, endothelial function analysis, and immunohistochemical and western blot analyses. Arsenic trioxide eluting stents effectively inhibited local inflammatory reactions, while no significant difference in endothelialization and endothelial function between arsenic trioxide eluting stents and bare metal stents was observed. Arsenic trioxide eluting stents favorably modulate neointimal formation due to less augmentation of early inflammatory reactions, and quick endothelialization of the stent surface, which might contribute to long-term safety and efficacy of drug eluting stents.

scholarly journals A Single-Center Study on the Outcomes of Target Limb Revascularization in Femoropopliteal Lesions Treated With Drug Coated Balloons and Bare Metal Stents

2022 ◽  
pp. 152660282110687
Author(s):  
Victoria Linehan ◽  
Maria Doyle ◽  
Brendan Barrett ◽  
Ravindra Gullipalli
Keyword(s):  
Bare Metal Stents ◽  
Retrospective Chart Review ◽  
Target Lesion ◽  
Endovascular Intervention ◽  
Metal Stents ◽  
Bare Metal ◽  
Single Center ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Intervention Patient

Purpose: Multiple randomized controlled trials have shown that both drug coated balloons (DCBs) and bare metal stents (BMSs) significantly reduce restenosis in femoropopliteal lesions compared with plain balloon angioplasty. However, few studies have directly compared DCB and BMS treatments. Therefore, the goal of our study was to determine if the rate of target lesion revascularization (TLR) differs between DCB and BMS treatment at our center. Materials and methods: We performed a retrospective chart review of femoropopliteal interventions at a single center from 2009 to 2017. The intervention, patient and lesion characteristics, and TLR events were recorded. Exclusion criteria were loss of follow-up, death, bail-out stenting, and amputation within 60 days of treatment. Freedom from TLR was analyzed over a 3 year period with Kaplan-Meier survival curves. Cox hazard ratios were calculated to account for patient and lesion characteristics. Results: A total of 322 lesions (234 patients) treated with DCBs and 225 lesions (194 patients) treated with BMSs were included in this study. There were significant differences in baseline patient and lesion characteristics between groups—a greater proportion of women, patients with dyslipidemia, and lesions with popliteal involvement were treated with DCBs. There was no difference in the freedom from TLR between DCBs and BMSs. Accounting for patient and lesion characteristics, there was still no difference between DCBs and BMSs on the hazard of TLR. While our analysis did not detect a difference in the rate of TLR, there was a significant difference in the type of TLR. Compared with DCBs, a greater proportion of lesions initially treated with BMSs were retreated via surgical bypass rather than endovascular intervention, suggesting that lesions treated with DCBs may be more amenable to future endovascular intervention. Conclusion: Our retrospective analysis showed no difference in the rate of TLR between lesions treated with DCBs and BMSs. However, DCBs were more often used in complicated lesions involving popliteal arteries and may also allow for easier endovascular reintervention.

Abstract WMP44: A Meta-Analysis of Drug Eluting Stents vs Bare Metal Stents for Treatment of Extracranial Vertebral Artery Disease

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Nakul Sheth ◽  
Vikas Gupta ◽  
Wenzhuan He ◽  
Shariyah Gordon ◽  
Charles J Prestigiacomo ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Clinical Success ◽  
Meta Analysis ◽  
Bare Metal Stents ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Significant Difference ◽  
Drug Eluting ◽  
Extracranial Vertebral Artery

A Meta-Analysis of Drug Eluting Stents vs. Bare Metal Stents for Treatment of Extracranial Vertebral Artery Disease Background: —Although a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared to bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial. Methods: —A search strategy was used using the terms "stents," "drug-eluting stents," "atherosclerosis," "vertebral artery," and "vertebrobasilar insufficiency" through Medline. Five studies met the criteria for a comparative meta-analysis. The technical and clinical success, periprocedural complications, target vessel revascularization (TVR), rates of restenosis and recurrent symptoms and overall survival were compared between the DES and BMS groups using the Mantel-Haenszel method with fixed and random effect models. Results: —The mean pretreatment stenosis was 83.8±4.2% in the DES group (n = 156) and 80.12±2.7% in the BMS group (n = 148). There was no significant difference in the technical success (OR = 1.528, p = 0.622), clinical success (OR = 1.917, p = 0.274) and periprocedural complications (OR = 0.741, p = 0.614) between the two groups. The rates of technical success, clinical success and periprocedural complications were 98.78%, 95.77% and 1.94% for the DES group vs. 100%, 97.96% and 2.96% for the BMS group. There was no periprocedural mortality, stroke or TIA. The mean clinical and radiological follow-up times were 19.1±6.9 and 14.23±1.5 months respectively, for the DES arm and 26±7.6 and 20.5±3.3 months, respectively, for the BMS group. A 0.388 odds ratio of no-restenosis in the BMS to DES arms (p = 0.001) indicated a significantly higher restenosis rate in the BMS group relative to the DES group (33.57% vs. 15.49%, respectively). When compared with the DES group, the BMS group had a significantly higher rate of recurrent symptoms (2.76% vs. 11.26%; OR = 3.319, p = 0.011) and TVR (4.83% vs. 19.21%; OR = 4.099, p = 0.001). There was no significant difference between overall survival (OR = 0.655, p = 0.32). Conclusion: —A lower rate of restenosis, recurrent symptoms and target vessel revascularization was noted in the DES group.

Effect of drug-coated balloons versus bare-metal stents on endothelial function in patients with severe lower limb peripheral artery disease

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 548-556
Author(s):  
Omid Shafe ◽  
Jamal Moosavi ◽  
Mehdi H Shishehbor ◽  
Hamid Sedigh ◽  
Hooman Bakhshandeh ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Ankle Brachial Index ◽  
Bare Metal Stents ◽  
Vascular Diseases ◽  
Significant Rise ◽  
Metal Stents ◽  
Bare Metal ◽  
Reactive Hyperemia Index ◽  
Vessel Patency

Background Research shows impaired endothelial function in patients with vascular diseases and improved endothelial function following revascularization and medical treatment. There is, however, a dearth of data on the effects of different endovascular therapeutic strategies on endothelial function. We sought to compare the effects of two endovascular strategies of drug-coated balloons versus stenting on endothelial function. Methods The reactive hyperemia index, the ankle-brachial index, and the toe-brachial index were measured in patients undergoing endovascular revascularization preprocedurally and on the 90th postprocedural day. After adjusting for baseline line characteristics, reactive hyperemia index were compared between the two groups at baseline and at 90 days. Results Between January 2018 and March 2019, 86 patients were prospectively included in a non-randomized manner. Drug-coated ballooning alone was carried out on 46 patients, and bailout stenting after plain balloon angioplasty was performed on the remaining 40 patients The post-revascularization reactive hyperemia index exhibited a significant rise in both groups (1.58 ± 0.21 vs. 1.43 ± 0.20; P =  0.0001). There was no difference in the postprocedural reactive hyperemia index between the two treatment groups. Additionally, the follow-up reactive hyperemia index showed no significant change compared with the postprocedural reactive hyperemia index (1.58 ± 0.23 vs. 1.57 ± 0.22). The results of subgroup analysis between a group of clinically high-risk patients and a group of patients with complex lesions were similar to the aforementioned results. Conclusions The reactive hyperemia index was significantly improved by endovascular therapy in our study population. However, no difference was observed between drug-coated ballooning and bare-metal stenting, which highlights the effects of vessel patency on endothelial function.

scholarly journals Cardiovascular Outcomes in Patients on Hemodialysis following Drug-Eluting versus Bare-Metal Coronary Stents

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Amir F. Mohani ◽  
Srikanth Penumetsa ◽  
Amin Daoulah ◽  
Gregory Giugliano ◽  
Amir Lotfi
Keyword(s):  
High Mortality ◽  
Propensity Score Analysis ◽  
Conditional Logistic Regression ◽  
Bare Metal Stents ◽  
Cardiovascular Outcomes ◽  
Metal Stents ◽  
Bare Metal ◽  
Significant Difference ◽  
Drug Eluting ◽  
One Year

Aim. This study sought to compare short- and long-term outcomes of drug-eluting stents (DESs) versus bare-metal stents (BMSs) implantation in patients with end-stage renal disease on hemodialysis (ESRD-HD) undergoing percutaneous coronary intervention (PCI). Methods. Adult patients with ESRD-HD who underwent PCI at all nonfederal hospitals in Massachusetts between July 1, 2003, and September 30, 2007, were stratified based on the stent type placed at index hospitalization: DES or BMS. The primary outcome compared was a composite of all-cause death, myocardial infarction (MI), congestive heart failure (CHF), target vessel revascularization (TVR), and stroke at 30 days and one year. Results. HD patients had a high mortality (31%) and were more likely to receive a DES than a BMS (77% versus 23%). Propensity score analysis of 2 : 1 matched DES (268) versus BMS (134) patients demonstrated the DES group to more likely have proximal LAD disease and a history of prior PCI. Conditional logistic regression analysis demonstrated no significant difference in the composite cardiovascular endpoint measured at 30 days (hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.61–1.94) and one year (HR 1.03; 95% CI 0.68–1.57). Conclusions. There were no significant differences in 30-day or 1-year major cardiovascular outcomes in HD patients undergoing PCI using the DES compared to the BMS in this high-mortality patient cohort.

Abstract 3442: Pattern and Time Path of Neonintimal Healing in Drug Eluting versus Bare Metal Stents in the Rat Aortic Stent Model

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hendrik C Groenewegen ◽  
Anton J Roks ◽  
Maaike Goris ◽  
Felix Zijlstra ◽  
Wiek H van Gilst ◽  
...  
Keyword(s):  
Cell Density ◽  
Bare Metal Stents ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Neointimal Formation ◽  
Neointimal Thickness ◽  
Incomplete Healing ◽  
Drug Eluting ◽  
Inflammation Score

Purpose:to determine if the neointima of drug-eluting stents is histological different from their bare metal controls. Neointimal formation in stented aortas was evaluated quantatively and qualitatively at two time points. Methods:male Wistar rats were randomized to one of four groups: Express 2 stent , Taxus Express 2 stent , Bx Velocity stent and Cypher stent. Stents were implanted in the abdominal aorta. Histological analyses were performed after 1 and 4 weeks. After 1 week the inflammation score and neointimal cell density was measured. Stented aortas were also examined for acellularity of neointima and /or the presence of a hemorrhage in the neointima. After 4 weeks the same measurements were performed plus the neointimal area and neointimal thickness. Results:no differences were observed after 1 week between bare metal stents and drug-eluting stents. At 4 weeks neointimal cell density was lower and inflammation-score was higher in the drug eluting stents. Furthermore in less than 10% of the bare metal stents acellularity of neointima and/or hemorrhage was found. On the contrary, in more than 90% of the drug eluting stents acellularity of neointima and/or hemorrhage was seen. Neointima area and neointimal thickness was reduced in the drug-eluting stents. No histological differences were found between the paclitaxel and the sirolimus eluting stent. Conclusions:Both drug eluting stents are effective in reducing neointimal formation however in both drug eluting stents acellular areas were observed in the neointima of almost every single stent. This is likely to be a reflection of incomplete healing which persists after neointimal formation has peaked. Table 1. Histological measurements: results in the 4 week groups.

Abstract 20552: Comparison of Outcome in Patients With ST-Elevation Myocardial Infarction Treated with Drug-Eluting Stents versus Bare Metal Stents in Eastern Denmark and Southern Sweden

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Homa Waziri ◽  
Erik Jorgensen ◽  
Henning Kelbaek ◽  
Martin Stagmo ◽  
Frants Pedersen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bare Metal Stents ◽  
St Elevation Myocardial Infarction ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Southern Sweden ◽  
Significant Difference ◽  
Drug Eluting ◽  
St Elevation

The prognosis of patients with ST-elevation myocardial infarction (STEMI) has improved significantly in the era of mechanical revascularization. Regional differences exist in the choice of stents. The aim of this study was to assess whether differences in preference of stents effect outcome in Danish and Swedish STEMI patients treated with either drug-eluting stents (DES) or bare metal stents (BMS) during percutaneous coronary intervention (PCI) in Eastern Denmark and Southern Sweden, respectively. Methods: We included 14,260 consecutive STEMI patients from 2003-2012 (59,708 patient-years of follow-up) treated in Eastern Denmark and Southern Sweden with either DES or BMS. Data were obtained from the Eastern Danish Heart Registry and the Swedish Coronary Angiography and Angioplasty Registry. Results: We identified 7828 (54.9%) Danish and 6,432 (45.1%) Swedish patients. Among Danish patients 76% (n=5966) received DES whereas 82% (n= 5254) of the Swedish patients received BMS. Overall 7116 (49.9%) patients were treated with DES and 7144 (50.1%) with BMS. Patients who received BMS were older (65.9 vs. 63.0) with a higher prevalence of hypertension (38.9 % vs. 36.3%) and history of myocardial infarction (13.0% vs. 9.2%) but with a lower prevalence of smoking (42.1% vs. 50.7%) and hyperlipidemia (20.7% vs. 24.3%, all p<0.01). Patients with BMS had a higher risk adjusted 30-day mortality (hazard ratio [HR] =1.3, CI 1.02-1.68, p<0.001) compared with DES. There was no statistically significant difference in mortality after 30 days and onwards (HR=0.96, CI 0.83-1.1, p=0.59) Conclusions: The use of DES is associated with a significantly lower 30-day mortality compared with BMS. After 30-days there is no difference in mortality between DES and BMS.

Abstract 1685: Clinical and Angiographic Outcomes following Percutaneous Coronary Intervention with Sirolimus-Eluting Stents vs. Bare Metal Stents in Hemodialysis Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sen Yachi ◽  
Kengo Tanabe ◽  
Hirosada Yamamoto ◽  
Shuji Otsuki ◽  
Atsuhiko Yagishita ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Hemodialysis Patients ◽  
Metal Stents ◽  
Control Group ◽  
Bare Metal ◽  
Percutaneous Coronary ◽  
Significant Difference

Background Percutaneous coronary intervention in hemodialysis patients has been hampered by high rate of major adverse cardiac events (MACE). It remains uncertain whether sirolimus-eluting stent (SES) improves clinical outcomes in hemodialysis patients compared to bare metal stent (BMS). Methods The present study consisted of consecutive 46 hemodialysis patients with 57 lesions treated with SES from August 2004 to April 2006. For comparison, the control group was composed of 67 hemodialysis patients with 70 lesions who were treated with BMS in three years before the introduction of SES. Clinical and angiographic follow-up were performed after 8 months. MACE included all-cause death, myocardial infarction and repeat target vessel revascularization. Results Baseline characteristics were comparable between the 2 groups except for lesion length. Clinical follow-up was available in all patients. Angiographic follow-up was obtained in 39 patients (84.8%) in the SES group and 49 patients (73.1%) in the BMS group. There was no difference in MACE between the 2 groups (SES;28.3%, BMS;40.3%, p=0.19). As shown in the table , quantitative angiographic analysis revealed a significant difference in late lumen loss (SES;0.66±0.80mm, BMS;1.07±0.75mm, p=0.01), however, the rate of binary restenosis was identical (SES;31.9%, BMS;40.4%, p=0.38). Of the angiographic restenosis lesions analyzed, focal restenosis pattern was frequently observed in the SES group than the BMS group(SES;93.3%, BMS;23.8%, p<0.0001), whereas diffuse restenosis pattern was dominant in the BMS group. Conclusion Angiographic parameters favored inhibition of neointimal hyperplasia by SES. However, the inhibitory effect of sirolimus was not translated into clinical superiority over BMS in hemodialysis patients. Table. Serial QCA data

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