A Case Report of Cangrelor Bridge Therapy for a Diagnostic Bronchoscopy With Biopsy

2018 ◽  
Vol 33 (2) ◽  
pp. 231-235 ◽  
Author(s):  
Matthew W. Calnan ◽  
Alexis N. Crawford
Keyword(s):  
Lung Cancer ◽  
Bleeding Complications ◽  
Drug Eluting Stent ◽  
Diagnostic Bronchoscopy ◽  
Obese Female ◽  
Increased Risk ◽  
Ischemic Complications ◽  
Drug Eluting ◽  
Diagnosis Of Lung Cancer ◽  
Bridge Therapy

Although premature discontinuation of dual antiplatelet therapy (DAPT) is associated with an increased risk of ischemic complications, patients may present with an urgent need for surgery that would require interruption of DAPT. Antiplatelet bridge therapy using cangrelor, an intravenous P2Y12 inhibitor, has been studied as a potential option to ensure continuation of DAPT perioperatively. However, limited evidence exists supporting the off-label use of cangrelor bridge therapy to noncardiac procedures. We describe the case of a 67-year-old class 3 obese female on DAPT (aspirin and ticagrelor) for recent drug-eluting stent placement who required a bronchoscopy with biopsy for suspected lung cancer. Cangrelor bridge therapy was utilized both preoperatively and postoperatively without ischemic or bleeding complications, and the patient was subsequently able to begin radiation therapy after a confirmed diagnosis of lung cancer.

scholarly journals Efficacy of Cangrelor as Bridging Therapy Post PCI

2020 ◽  
Vol 20 (3) ◽  
pp. 227-231
Author(s):  
Abdul A. Khan ◽  
Ghulam Murtaza ◽  
Muhammad Khalid ◽  
Mathew Finniss ◽  
Thomas Helton
Keyword(s):  
High Risk ◽  
Bleeding Complications ◽  
Drug Eluting Stent ◽  
Cardiac Procedures ◽  
Surgery Patient ◽  
Ischemic Complications ◽  
Risk Patients ◽  
Drug Eluting ◽  
Acute Stent Thrombosis ◽  
Bridge Therapy

Background: Dual antiplatelet therapy (DAPT) remains the cornerstone management for the prevention of acute stent thrombosis after percutaneous intervention (PCI). Situations mandating early interruption of DAPT carry a high risk of ischemic complications. Perioperative bridge therapy using Cangrelor, an intravenous P2Y2 inhibitor, may offer a potential solution. Unfortunately, evidence for its use in non-cardiac procedures is limited. Methods: Our protocol demonstrates successful off-label use of IV Cangrelor bridge therapy in a non-cardiac surgery patient. We describe a case of a 77-year old male; triple therapy with Aspirin, Apixaban, and Ticagrelor for recent drug-eluting stent placement required immediate surgical resection of stage I colonic adenocarcinoma. Results: Cangrelor bridge therapy was utilized both preoperatively and postoperatively without ischemic or bleeding complications. The patient tolerated exploratory laparoscopic colectomy with minimal bleeding and good post-op recovery. Conclusion: Minimizing the interruption of DAPT therapy in high-risk patients is achievable. However, careful planning with a team-based approach involving surgeons, cardiologists and pharmacists, along with close clinical follow-up and vigilant management of anti-platelet therapy is recommended.

Comparative Efficacy and Safety of Duration of Dual Antiplatelet Therapy in Patients with CAD Undergoing Drug-eluting Stent Implantation: A Systematic Review and Network Meta-analysis

2020 ◽  
Vol 26 (44) ◽  
pp. 5739-5745
Author(s):  
Jieqiong Guan ◽  
Wenjing Song ◽  
Pan He ◽  
Siyu Fan ◽  
Hong Zhi ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Major Bleeding ◽  
Dual Antiplatelet Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Drug Eluting Stent ◽  
Efficacy And Safety ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Drug Eluting

Objective: The aim was to evaluate the efficacy and safety of duration of dual antiplatelet therapy (DAPT) for patients who received percutaneous coronary intervention (PCI) with a drug-eluting stent. Background: The optimal duration of DAPT to balance the risk of ischemia and bleeding in CAD patients undergoing drug-eluting stent (DES) implantation remains controversial. Methods: PubMed, Cochrane Library, Web of Science, Clinicaltrials.gov, CNKI and Wanfang Databases were searched for randomized controlled trials of comparing different durations of DAPT after DES implantation. Primary outcomes were major adverse cardiac and cerebrovascular events (MACCE), and major bleeding, and were pooled by Bayes network meta-analysis. Net adverse clinical and cerebral events were used to estimate the surface under the cumulative ranking (SUCRA) curves. The subgroup analysis based on clinical status, follow-up and area was conducted using traditional pairwise meta-analysis. Results: A total of nineteen trials (n=51,035) were included, involving six duration strategies. The network metaanalysis showed that T2 (<6-month DAPT followed by aspirin, HR:1.51, 95%CI:1.02-2.22), T3 (standard 6-month DAPT, HR:1.47, 95%CI:1.14-1.91), T4 (standard 12-month DAPT, HR:1.41, 95%CI:1.15-1.75) and T5 (18-24 months DAPT, HR:1.47, 95%CI:1.09-1.97) was associated with significantly increased risk of MACCE compared to T6 (>24-month DAPT). However, no significant difference was found in MACCE risk between T1 (<6-month DAPT followed by P2Y12 monotherapy) and T6. Moreover, T5 was associated with significantly increased risk of bleeding compared to T1(RR:3.94, 95%CI:1.66-10.60), T2(RR:3.65, 95%CI:1.32-9.97), T3(RR:1.93, 95%CI:1.21-3.50) and T4(RR:1.89, 95%CI:1.15-3.30). The cumulative probabilities showed that T6(85.0%), T1(78.3%) and T4(44.5%) were the most efficacious treatment compared to the other durations. In the ACS (<50%) subgroup, T1 was observed to significantly reduce the risk of major bleeding compared to T4, but not in the ACS (≥50%) subgroup. Conclusions: Compared with other durations, short DAPT followed by P2Y12 inhibitor monotherapy showed non-inferiority, with a lower risk of bleeding and not associated with an increased MACCE. In addition, the risk of major bleeding increased significantly, starting with DAPT for 18-month. Compared with the short-term treatment, patients with ACS with the standard 12-month treatment have a better prognosis, including lower bleeding rate and the decreased risk of MACCE. Due to study's limitations, the results should be verified in different risk populations.

Abstract 19660: Scoring System to Predict Major Bleeding Complications in Atrial Fibrillation Patients With Oral Anticoagulant After Drug-eluting Stent Implantation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Norihiro Kobayashi ◽  
Yoshiaki Ito ◽  
Keisuke Hirano ◽  
Masahiro Yamawaki ◽  
Motoharu Araki ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Major Bleeding ◽  
Scoring System ◽  
Oral Anticoagulant ◽  
Logistic Regression Model ◽  
Risk Group ◽  
Bleeding Complications ◽  
Drug Eluting Stent ◽  
Drug Eluting

Background: We aimed to introduce scoring system to predict major bleeding complications after triple antithrombotic therapy (TAT) in patients with atrial fibrillation (AF) and drug-eluting stent (DES) implantation. Methods: Between April 2007 and December 2011, 119 patients with AF and DES implantation were enrolled in this study. All of these patients received oral anticoagulant therapy and dual antiplatelet therapy (DAPT). We investigated the incidence of major bleeding complications including intracranial and gastrointestinal bleeding. Each variables which seem to be associated with major bleeding complications were analyzed using the univariate logistic regression model. All variables tested in univariate analysis with p<0.10 were included in multivariate logistic regression model. The scores for each variables were transformed from regression coefficients and computed in a total score. Results: The mean follow-up period was 43.6 ± 25.5 month. The incidence of major bleeding was 17.6%. In multivariate analysis, age > 75 (OR 3.67, 95%CI 1.01-13.3, p = 0.048), continuation of DAPT (OR 7.85, 95%CI 1.50-41.2, p = 0.015), INR > 2.2 (OR 9.19, 95%CI 2.65-31.9, p < 0.001) were predictors of major bleeding complications. Each item’s score ranged from 0 to 2 and the total score ranged from 0 to 5. The area under the receiver operating characteristics curve revealed that there was 82.8% accuracy in the total scores predicting the likelihood of major bleeding complications. The rate of major bleeding complications was 2.3% in low-risk group (scores 0-1), 20.0% in moderate-risk group (scores 2-3), and 53.3% in high-risk group (scores 4-5) (p<0.001). Conclusions: This scoring system is useful for the risk stratification of major bleeding complications in AF patients with TAT after DES implantation.

Abstract 40: Hospital Variation in Premature Clopidogrel Discontinuation following Drug Eluting Stent Placement and Adverse Cardiovascular Outcomes from the VA Clinical Assessment, Reporting, and Tracking System for Cath Labs (CART-CL)

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rebecca Vigen ◽  
Thomas M Maddox ◽  
Colin O'Donnell ◽  
Deepak L Bhatt ◽  
Thomas T Tsai ◽  
...  
Keyword(s):  
Tracking System ◽  
Adverse Outcomes ◽  
Drug Eluting Stents ◽  
Drug Eluting Stent ◽  
Hospital Level ◽  
Pharmacy Refill ◽  
Hospital Variation ◽  
Increased Risk ◽  
Drug Eluting ◽  
Clopidogrel Therapy

Background: Clopidogrel is recommended for 1 year following drug eluting stent (DES) placement and premature discontinuation has been associated with adverse outcomes. The extent of variation in premature discontinuation across hospitals within an integrated healthcare system is unknown. Accordingly, we assessed variation in premature clopidogrel discontinuation across all VA PCI sites and whether there was an association between hospitals with higher rates of premature discontinuation and adverse outcomes. Methods: We used the VA CART-CL registry which includes all PCIs with drug eluting stents performed between 10/01/08 and 09/30/09 at 55 VA cath labs that used CART. We evaluated the frequency of patients who prematurely discontinue clopidogrel at 6 and 9 months using pharmacy refill data. Multivariable regression assessed the association between premature discontinuation and all-cause mortality and/or myocardial infarction (MI). We then grouped sites into quartiles of premature discontinuation and evaluated the association between hospital level premature discontinuation and adverse outcomes. Results: Of the 7,022 patients who received a DES, 6.3% discontinued by 6 months, and 10.2% by 9 months. After risk adjustment, patients who discontinued clopidogrel prematurely had increased risk of adverse events with HR of 5.42 at 6 months (95% CI 4.22 – 6.99), and 6.24 at 9 months (95% CI 4.98 – 7.83). There was a significant trend in the unadjusted rates within quartiles toward increased risk of adverse outcomes among hospitals with greater rates of patients who discontinue prematurely by 6 months (p < 0.01 for trend, OR 1.65 CI 1.07 – 2.62 for comparison between quartile 1 and 4). Conclusion: Premature discontinuation of clopidogrel is associated with adverse outcomes among patients who receive drug eluting stents. Hospitals with higher rates of premature discontinuation of clopidogrel have higher rates of adverse outcomes. Hospital-level interventions to reduce early discontinuation of clopidogrel therapy have the potential to improve outcomes of patients who receive a DES.

scholarly journals Prognostic Value of VEGF in Patients Submitted to Percutaneous Coronary Intervention

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Catarina Ramos ◽  
Patrícia Napoleão ◽  
Mafalda Selas ◽  
Cláudia Freixo ◽  
Ana Maria Viegas Crespo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Cardiac Events ◽  
Positive Role ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Previous Medication ◽  
Drug Eluting ◽  
Artery Disease

We examined the longitudinal changes of VEGF levels after percutaneous coronary intervention for predicting major adverse cardiac events (MACE) in coronary artery disease (CAD) patients. VEGF was measured in 94 CAD patients’ serum before revascularization, 1-month and 1-year after. Independently of clinical presentation, patients had lower VEGF concentration than a cohort of healthy subjects (median, IQ: 15.9, 9.0–264 pg/mL versus 419, 212–758 pg/mL;P<0.001) at baseline. VEGF increased to 1-month (median, IQ: 276, 167–498 pg/mL;P<0.001) and remained steady to 1-year (median, IQ: 320, 173–497 pg/mL;P<0.001) approaching control levels. Drug eluting stent apposition and previous medication intake produced a less steep VEGF evolution after intervention (P<0.05). Baseline VEGF concentration <40.8 pg/mL conveyed increased risk for MACE in a 5-year follow-up. Results reflect a positive role of VEGF in recovery and support its importance in CAD prognosis.

scholarly journals Diagnostic bronchoscopy: an experience in a hospital of limited resources

2018 ◽  
Vol 6 (11) ◽  
pp. 3558
Author(s):  
Chingakham Debeshwar Singh ◽  
P. Wilubuibou ◽  
Thounaojam Amusana Singh
Keyword(s):  
Lung Cancer ◽  
Nucleic Acid Amplification ◽  
Limited Resources ◽  
Sputum Smear ◽  
X Ray ◽  
Medical College ◽  
Diagnostic Bronchoscopy ◽  
Chest X Ray ◽  
Set Up ◽  
Diagnosis Of Lung Cancer

Background: Diagnostic bronchoscopy is conventionally performed in evaluating undiagnosed abnormal chest x-ray findings, undiagnosed haemoptysis, pleural effusion, unexplained cough and collapse of lung etc. One indispensable use currently is for diagnosis of lung cancer. The aim of the study was to study the various types of patients who have undergone Diagnostic Bronchoscopy in a hospital of limited resources and the diagnostic outcomes of the procedures.Methods: A retrospective study of Bronchoscopies was done from October 2016 to January 2018, in Department of Respiratory Medicine in the hospital of a Medical College. All 178 patients of all age and any sex were included in the study. These patients present in the study had chest X-ray and CT scan of thorax. Other investigations done were ZN stains for AFB and CBNAAT-TB (Cartridge Based Nucleic Acid Amplification Test) for sputum and blood complete haemogram, prior to bronchoscopy.Results: Our study has shown that Diagnostic bronchoscopy is particularly useful in diagnosis of lung cancer, sputum smear negative Tuberculosis, if proper selection of cases is done even in a centre of limited resources. It has become an absolute necessity in a medical college hospital.Conclusions: Bronchoscopy in our resource limited set up shows that it is an indispensable tool for diagnosis of lung cancer with patients with clinical presentations of lung collapse, unresolved consolidation, lung masses, undiagnosed pleural effusions and haemoptysis. The usefulness can be much better if facilities like TBNA, EBUS are made available.

scholarly journals Akut coronaria szindrómán átesett thrombocytopeniás betegek thrombocytaaggregáció-gátló gyógyszeres kezelése

2021 ◽  
Vol 162 (33) ◽  
pp. 1335-1340
Author(s):  
Ágnes Fehér ◽  
Ildikó Istenes ◽  
Júlia Weisinger ◽  
Péter Király ◽  
Anna Rakonczai ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Bleeding Risk ◽  
Bare Metal Stent ◽  
Bleeding Complications ◽  
Drug Eluting Stent ◽  
Coronary Syndrome ◽  
Length Of Treatment ◽  
Drug Eluting ◽  
New Generation

Összefoglaló. Az akut coronaria szindrómán (ACS) átesett betegek kezelésének alappillére a kettős (aszpirin + klopidogrél ) thrombocytaaggregáció-gátló kezelés. Az immunthrombocytopeniás purpurás (ITP-s) betegek – és különösen azok, akik refrakter ITP miatt thrombopoetinanalóg kezelésben részesülnek – külön elbírálást igényelnek. 50–100 G/l thrombocytaszám közötti és vérzéses szövődménnyel nem rendelkező ACS-s betegeken a gyógyszerkibocsátó stent beültetését követően kettős thrombocytaaggregáció-gátló kezelést csak 1 hónapig kell alkalmazni (ez az időtartam átlagos vérzéses rizikójú betegeken 1 év), majd klopidogrél-monoterápia javasolt. Munkánk során a 2015. január 1. és 2020. október 1. között a Semmelweis Egyetem I. Belgyógyászati Klinikáján kezelt ITP-s betegek körében vizsgáltuk az ACS előfordulását és lefolyását. Klinikánkon az elmúlt 5 évben gondozott, 168 ITP-s beteg közül 3 beteg esetében alakult ki ACS. A refrakter ITP kezelésének részeként mind a 3 beteg thrombopoetinanalóg - (2 beteg romiplosztim-, 1 beteg eltrombopág-) kezelésben részesült. A 3 ITP-s betegünk egyikénél sem alakult ki vérzéses szövődmény a thrombopoetinanalóg-kezelés és a thrombocytaaggregáció-gátlás mellett. Első betegünk esetében 5 év alatt három alkalommal alakult ki ACS (egy ízben fémstentet és két alkalommal gyógyszerkibocsátó stentet kapott). A második betegnél két alkalommal (1 év különbséggel), a harmadik betegnél egy esetben történt gyógyszerkibocsátó stent beültetése. ITP és ACS együttes fennállása esetén az akut és a hosszú távú gyógyszeres kezelés egyéni mérlegelést igényel. Ezen speciális betegcsoport számára a kezelési irányelv kidolgozása megfontolandó. Orv Hetil. 2021; 162(33): 1335–1340. Summary. Dual antiplatelet therapy (DAPT) consisting of aspirin and clopidogrel is essential in the treatment of acute coronary syndrome (ACS). Immune thrombocytopenic purpura (ITP) patients – and especially those receiving thrombopoietin analog (TPO) treatment – deserve special attention. In ACS patients with platelet counts between 50 G/L and 100 G/L and no bleeding symptoms, DAPT is indicated for 1 month after the placement of new generation drug-eluting stents (the length of treatment is 1 year in the case of patients with average bleeding risk) followed by clopidogrel monotherapy. In patients with average bleeding risk, DAPT is recommended for 1 year after the ACS. Our aim was to investigate the incidence and outcome of ACS in ITP patients, who were treated in our clinic between 1st January 2015 and 1st October 2020. Out of 168 patients treated for ITP, 3 patients suffered from ACS in the last 5 years. These patients received TPO treatment (2 patients subcutan romiplostim, 1 patient oral eltrombopag). None of these ITP patients treated with DAPT and with TPO analog suffered from bleeding complications. 1 patient developed ACS three times within the last 5 years (he received bare-metal stent once and drug-eluting stent twice). Drug-eluting stent was placed once in the third, and twice (with 1 year difference) in the second patient. Acute and long-term medication of patients suffering from both ITP and ACS is a challenging task and needs individual evaluation. Establishment of treatment guidelines for this special group is warranted. Orv Hetil. 2021; 162(33): 1335–1340.

P686Cancer is not associated with increased cardiac and bleeding events after 2nd- and 3rd-generation drug-eluting stents implantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Muramatsu ◽  
Y Minami ◽  
K Ishida ◽  
A Kato ◽  
A Katsura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Cardiac Events ◽  
Bleeding Events ◽  
Patients With Cancer ◽  
Cancer Group ◽  
Increased Risk ◽  
Drug Eluting ◽  
The Impact

Abstract Background Previous studies demonstrated the impact of concomitant cancer on the increased risk of adverse cardiac and bleeding events after percutaneous coronary intervention (PCI). However, the impact in this 2nd- and 3rd-generation drug-eluting stent (DES) era remains to be elucidated. Purpose To clarify the impact of cancer on clinical outcomes in patients after 2nd- or 3rd -generation DES implantation. Methods A total of 932 patients who underwent PCI with 2nd- or 3rd -generation DES were included. Patients who were diagnosed with cancer after PCI were excluded from the present cohort. The incidence of major adverse cardiac events (MACE) including cardiac death, myocardial infarction and target or non-target vessel revascularization, and bleeding events was compared between the patients with cancer or the history of treatment for cancer (cancer group, n=140) and the patients without cancer (no cancer group, n=792). Bleeding events were evaluated according to the Thrombolysis in Myocardial Infarction definition. Further comparisons were performed between the 2 groups (cancer group, n=126; no cancer group, n=252) after the adjustment of baseline clinical characteristics using 1:2 propensity score-matching analysis. Results The incidence of MACE at median 577 [340–1043] days after the PCI was comparable between the 2 groups in both unadjusted (15.0% vs. 15.0%, p=0.984) (Panel A) and adjusted cohorts (14.3 vs. 13.1%, p=0.796), although the incidence of all cause death in the cancer group was significantly greater than the no cancer group (15.1 vs. 9.5%, p=0.007, in the adjusted cohort). The increased risk of MACE was not observed in any types of cancer or treatment (Panel B). The incidence of bleeding events was also comparable between the 2 groups (4.0 vs. 2.0%, p=0.297, in the adjusted cohort). Conclusion The increased incidence of MACE and bleeding events in patients with cancer was not demonstrated after the 2nd- or 3rd-generation DES implantation. Further studies are required to clarify the safety and efficacy of PCI in patients with cancer.

Abstract 561: A Novel Integrin Modulating Arg-Gly-Asp(RGD)-Peptide-Coated Stent Reduces Neoatherosclerosis in a Rabbit Model

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Liang Guo ◽  
Tobias Koppara ◽  
Qi Cheng ◽  
Eduardo Acampado ◽  
Frank D Kolodgie ◽  
...  
Keyword(s):  
Thrombus Formation ◽  
Rabbit Model ◽  
Bare Metal Stents ◽  
Drug Eluting Stents ◽  
Drug Eluting Stent ◽  
Metal Stents ◽  
Cholesterol Diet ◽  
Increased Risk ◽  
Drug Eluting ◽  
Low Cholesterol

Objective: While drug-eluting stents have dramatically reduced restenosis, they are often associated with increased risk of late stent thrombosis and neointimal atherosclerosis (“neoatherosclerosis”). In-stent neoatherosclerosis represents a further accelerated and possibly more unstable manifestation of atherosclerotic progression in nascent neointimal tissue after stent implantation. We hypothesized that poor arterial re-endothelialization accompanied by leaky endothelial junctions is a primary mechanism contributing to neoatherosclerosis. In the present study, we tested the ability of a RGD-peptidomimetic-coating of bare metal stents to reduce the formation of in-stent neoatherosclerosis by promoting integrin-mediated adhesion of endothelial cells, and improving their functional integrity. Approach and Results: Established iliofemoral plaques were created in male New Zealand white rabbits (n=10) by balloon injury and feeding a high cholesterol (1.0%) diet for 5 wks, which was then switched to a low cholesterol diet (0.025%) for the remainder of the study. At 3 wks after diet switch, an RGD-coated stent was implanted together with a drug-eluting stent in the contralateral iliac artery, and animals were continued on the low cholesterol diet for 7 wks (serum cholesterol between 400-1,000 mg/dl). Endothelial permeability was assessed by FITC-dextran (250/500 kDa, approx. LDL radius) injected intravenously 1 h before termination. Oil red O and Filipin staining demonstrated neutral lipid and free cholesterol accumulation in the developing neointimal of stented arteries. En face confocal microscopy of the luminal surface following immunostaining against endothelial markers followed by scanning electron microscopy showed greater endothelial coverage of luminal surfaces for RGD-coated stents. Stents were further quantified by histomorphometric analysis for vascular healing, thrombus formation and inflammation. Conclusion: A rabbit neoatherosclerosis model was established to study the formation and progression of this novel disease manifestation. RGD-coated stents showed reduced formation of neoatherosclerosis in association with improved vessel healing and re-endothelialization compared to drug-eluting stents.

A Polymer-Free Drug-Eluting Stent: In Vitro and In Vivo Analysis

2012 ◽  
Author(s):  
Saami K. Yazdani ◽  
Qi Cheng ◽  
Debashis Dutta ◽  
Frank D. Kolodgie ◽  
Renu Virmani
Keyword(s):  
Bare Metal Stents ◽  
Drug Eluting Stent ◽  
Metal Stents ◽  
Increased Risk ◽  
Optimal Surface ◽  
Drug Eluting ◽  
In Vivo Analysis ◽  
High Level

Drug-eluting stents (DES) have significantly improved restenosis rates as compared to bare metal stents (BMS), however, an increased risk in late stent thrombosis (LST) has been observed due to delayed healing and incomplete endothelialization. These adverse events have been associated to the high level of anti-proliferative drugs eluted from 1st generation DES, as well as non-erodible polymers that remain intact. The purpose of this study was to fist determine optimal surface modification in vitro and to then assess trends in endothelial coverage and recovery of the modified non-polymeric DES in a rabbit iliac stent model.

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