scholarly journals Comparison of 3D T1-SPACE and DSA in evaluation of intracranial in-stent restenosis

2020 ◽  
pp. 20190950
Author(s):  
Qiuji Shao ◽  
Qiang Li ◽  
Qiaowei Wu ◽  
Tianxiao Li ◽  
Li Li ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Stent Implantation ◽  
Pearson Correlation ◽  
Arterial Stenosis ◽  
Pearson Correlation Coefficient ◽  
Non Invasive ◽  
Stent Restenosis ◽  
Space Technique ◽  
In Stent Restenosis

Objective: In-stent restenosis (ISR) after stenting for intracranial stenosis is a significant issue. This study aimed to evaluate the usefulness of the 3D T1-SPACE technique in the follow-up of patients after stent implantation. Methods: Fifteen patients with intracranial arterial stenosis were prospectively enrolled 6–8 months after stenting. Digital subtraction angiography (DSA) and 3D T1-SPACE imaging were performed to evaluate the degree of stenosis and the enhancement of the vessel wall. Bland–Altman plots were used to assess the agreement between the two imaging methods, and the Pearson correlation coefficient was calculated as a measure of the linear correlation. Results: Eight Enterprise stents and seven Wingspan stents were used in 15 patients. The follow-up DSA after 6–8 months showed that the degree of stenosis was 40% (range, 30–72%), and ISR occurred in 4 of 15 (26.7%) lesions. The degree of stenosis assessed using the 3D T1-SPACE imaging technique was 35% (range, 30–75%). All four patients with ISR demonstrated significant enhancement. The Pearson correlation coefficient between the two methods was 0.959 (p < 0.05), and the Bland–Altman plot showed that all data points were within the consistency limits ([Formula: see text] ± 1.96 s). Conclusion: As a non-invasive imaging modality, 3D T1-SPACE showed great consistency with DSA in measuring the degree of stenosis after intracranial stenting. It may be used as an optional method for detecting ISR. Advances in knowledge: This study evaluated the usefulness of 3D T1-SPACE technique in the follow-up of patients after stent implantation, which could be used as an optional and non-invasive method in detection of in-stent restenosis.

Relationship between Invasive and Non-Invasive Hemodynamic Measures in Experimental Pulmonary Hypertension

2020 ◽  
Vol 16 (1) ◽  
pp. 47-53
Author(s):  
Vicente Benavides-Córdoba ◽  
Mauricio Palacios Gómez
Keyword(s):  
Heart Rate ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Systolic Pressure ◽  
Control Group ◽  
Pearson Correlation Coefficient ◽  
Non Invasive

Introduction: Animal models have been used to understand the pathophysiology of pulmonary hypertension, to describe the mechanisms of action and to evaluate promising active ingredients. The monocrotaline-induced pulmonary hypertension model is the most used animal model. In this model, invasive and non-invasive hemodynamic variables that resemble human measurements have been used. Aim: To define if non-invasive variables can predict hemodynamic measures in the monocrotaline-induced pulmonary hypertension model. Materials and Methods: Twenty 6-week old male Wistar rats weighing between 250-300g from the bioterium of the Universidad del Valle (Cali - Colombia) were used in order to establish that the relationships between invasive and non-invasive variables are sustained in different conditions (healthy, hypertrophy and treated). The animals were organized into three groups, a control group who was given 0.9% saline solution subcutaneously (sc), a group with pulmonary hypertension induced with a single subcutaneous dose of Monocrotaline 30 mg/kg, and a group with pulmonary hypertension with 30 mg/kg of monocrotaline treated with Sildenafil. Right ventricle ejection fraction, heart rate, right ventricle systolic pressure and the extent of hypertrophy were measured. The functional relation between any two variables was evaluated by the Pearson correlation coefficient. Results: It was found that all correlations were statistically significant (p <0.01). The strongest correlation was the inverse one between the RVEF and the Fulton index (r = -0.82). The Fulton index also had a strong correlation with the RVSP (r = 0.79). The Pearson correlation coefficient between the RVEF and the RVSP was -0.81, meaning that the higher the systolic pressure in the right ventricle, the lower the ejection fraction value. Heart rate was significantly correlated to the other three variables studied, although with relatively low correlation. Conclusion: The correlations obtained in this study indicate that the parameters evaluated in the research related to experimental pulmonary hypertension correlate adequately and that the measurements that are currently made are adequate and consistent with each other, that is, they have good predictive capacity.

Use of Multiple Visits to Increase Blood Pressure Tracking Correlations in Childhood

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 708-711
Author(s):  
Matthew W. Gillman ◽  
Bernard Rosner ◽  
Denis A. Evans ◽  
Laurel A. Smith ◽  
James O. Taylor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Correlation Coefficient ◽  
Diastolic Pressure ◽  
Pearson Correlation ◽  
Systolic Pressure ◽  
Pearson Correlation Coefficient ◽  
Increase Blood Pressure ◽  
Multiple Visit

Previous studies of childhood blood pressure have shown tracking correlations, which estimate the magnitude of association between initial and subsequent measurements, to be lower than corresponding adult values. Inasmuch as this disparity could arise from failing to account for a larger week-to-week variability in children, blood pressure was measured for 4 successive years, on four weekly visits in each year, and with three measurements at each visit, using a random-zero sphygmomanometer, in a cohort of 333 schoolchildren aged 8 through 15 at entry. Ninety percent of subjects had measurements in 1 or more years of follow-up. For all follow-up periods (1, 2, and 3 years from baseline), the Pearson correlation coefficient (r) for both systolic and diastolic blood pressure rose substantially with the number of weekly visits used to calculate each subject's yearly blood pressure (P &lt; .0001). For systolic pressure, the 3-year r values for 1, 2, 3, and 4 visits were .45, .55, .64, and .69, respectively. For diastolic pressure (Korotkoff phase 4), the corresponding values were .28, .41, .47, and .54. These higher multiple-visit estimates of tracking approximate published adult values and raise the possibility that prediction of adult blood pressure from childhood measurements may be improved by averaging readings from multiple weekly visits.

scholarly journals Plasma levels of miR-143 and miR-145 are associated with coronary in-stent restenosis within 1 year of follow-up after drug-eluting stent implantation

2020 ◽  
Vol 8 (12) ◽  
pp. 756-756
Author(s):  
Yuan Yuan ◽  
Xiaoxian Liu ◽  
Shengyun Hao ◽  
Qian He ◽  
Zheng Shen
Keyword(s):  
Stent Implantation ◽  
Plasma Levels ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Long-Term Clinical Follow-Up after Drug-Eluting Stent Implantation for Bare Metal In-Stent Restenosis

2013 ◽  
Vol 26 (3) ◽  
pp. 271-277
Author(s):  
BALAZS BERTA ◽  
ZOLTAN RUZSA ◽  
GYORGY BARCZI ◽  
DAVID BECKER ◽  
LASZLO GELLER ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Endovascular treatment of symptomatic intracranial stenosis with the Wingspan stent system and Gateway PTA balloon: a multicenter series of 60 patients with acute and midterm results

2011 ◽  
Vol 115 (4) ◽  
pp. 686-693 ◽  
Author(s):  
Vincent Costalat ◽  
Igor Lima Maldonado ◽  
Jean-François Vendrell ◽  
Carlos Riquelme ◽  
Paolo Machi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Recurrent Stroke ◽  
Neurological Complication ◽  
Arterial Stenosis ◽  
Technical Failure ◽  
Stent Restenosis ◽  
Stent System ◽  
The Mean ◽  
In Stent Restenosis

Object The limitations of the medical management of symptomatic intracranial arterial stenosis (SIAS) have encouraged the development of new strategies, such as endovascular treatment. In this study, the authors report and analyze a series of 63 endovascular procedures in which the Wingspan stent system was used. Methods Data from 60 patients presenting with refractory SIAS, treated in 5 French neurointerventional centers between September 2006 and August 2009, were retrieved. An angiogram was systematically obtained 6 months after the procedure and yearly thereafter. The clinical neurological status was assessed and reported using the modified Rankin scale at 1-month, 6-month, and 1-year follow-up visits. Results A total of 63 stenotic lesions was treated. The mean age of the patients was 65.3 years, and the mean diameter of the stenosis was 80.2%. Technical success was achieved in 95.2% of cases. The overall incidence of procedural complications was 20.6%, with a 4.8% rate of permanent postoperative morbidity and death. In-stent restenosis (ISR)/occlusion occurred in 11 cases (17.4%), of which 10 were asymptomatic and 9 were detected less than 1 year from the endovascular treatment. In 1 case, the patient presented with a recurrent transient ischemic attack and was treated again with angioplasty. The mean follow-up was 13.2 months. Conclusions Endovascular treatment of SIAS demonstrates a moderate risk of neurological complication. Nevertheless, considering the critical natural history of severe refractory lesions, this may be considered the first alternative in cases of failed medical therapy. Technical failure, residual stenosis, or in-stent restenosis did not lead to systematic recurrent stroke in this series, which suggests the importance of plaque stabilization and neoendothelialization.

Abstract 2156: In-Stent Restenosis after Sirolimus-Eluting Stent Implantation is Related to Coronary Stent Fracture

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
SY Lee ◽  
MH Kim ◽  
CM Ahn ◽  
JS Kim ◽  
DH Choi ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Stent Implantation ◽  
Time Interval ◽  
Stent Fracture ◽  
Fracture Group ◽  
Stent Restenosis ◽  
Sirolimus Eluting Stent ◽  
Stent Diameter ◽  
In Stent Restenosis

Background and objectives : It has been reported in few studies about relationship between sirolimus-eluting stent (SES) fracture and in-stent restenosis (ISR). Therefore, authors investigated clinical characteristics of the SES fracture and the association with ISR. Subjects and Methods : From December 2003 to February 2006, implantation and follow-up coronary angiography(CAG) for 796 sirolimus-eluting stents were carried out in Severance hospital. We reviewed clinical, procedural and structural factors which might affect SES fracture and ISR. Results : Twenty four fractures after 796 SES implantation were identified by follow-up coronary angiography, sixteen cases in the left anterior descending artery and eight in the right coronary artery. The median time interval from stent implantation to follow up CAG was 9.0 months [range: 2 ~ 30 months]. No statistical difference was found in stent diameter (fracture group 3.06 ± 0.32 mm vs non-fracture group 3.08 ± 0.31 mm, P=0.778). Length of fractured stents was longer than non-fractured stents (30.29 ± 4.16 mm vs 24.51 ± 6.18 mm, P<0.001). The binary ISR rate in the stent fracture group was higher compared to non-fracture group (50% vs 4.4%, p < 0.001). Predictors for ISR estimated by multivariate analysis were stent fracture (OR=33.6, p < 0.001), stent diameter less than 3.0 mm (OR=2.84, p =0.015) and stent length over 28 mm (OR = 3.10, p = 0.023). Among twelve cases which had both binary restenosis and stent fracture, eight cases were treated by balloon angioplasty or additional stent implantation considering the condition of patients. Conclusion : Stent fracture may be one of the crucial mechanisms of ISR after implantation of SES. However, further studies in larger scale are required to define the incidence, predisposing factors, and clinical outcomes of SES fracture.

Influence of insulin resistance on in-stent restenosis in patients undergoing coronary drug-eluting stent implantation after long-term angiographic follow-up

2015 ◽  
Vol 26 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Liang-Ping Zhao ◽  
Wei-Ting Xu ◽  
Li Wang ◽  
Hui Li ◽  
Chun-Lai Shao ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Five-year clinical follow-up after sirolimus-eluting stent implantation for the treatment of coronary in-stent restenosis

2011 ◽  
Vol 22 (3) ◽  
pp. 188-193 ◽  
Author(s):  
Thomas M. Schiele ◽  
Marcus Leibig ◽  
Johannes Rieber ◽  
Andreas König ◽  
Florian Krötz ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Stent Restenosis ◽  
Sirolimus Eluting Stent ◽  
In Stent Restenosis

scholarly journals Visit-to-Visit HbA1c Variability is Associated with In-Stent Restenosis in Patients with Type 2 Diabetes after Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Chen Die Yang ◽  
Ying Shen ◽  
Lin Lu ◽  
Zhen Kun Yang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Stent Implantation ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
The Mean ◽  
In Stent Restenosis

Abstract Background: Patients with type 2 diabetes are under substantially higher risk of in-stent restenosis (ISR) after coronary stent implantation. We sought to investigate whether visit-to-visit HbA1c variability is a potential predictor of ISR in diabetic patients after stent implantation.Methods: We consecutively enrolled type 2 diabetic patients who underwent successful elective percutaneous coronary intervention and performed follow-up coronary angiography after around 12 months. The incidence of ISR and its relationship with visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), standard deviation (SD) and variability independent of the mean (VIM), were studied. Multivariable Cox proportional hazards models were constructed to analyze the predictive value of HbA1c variability for ISR.Results: From September 2014 to July 2018 in Ruijin Hospital, a total of 420 diabetic patients (688 lesions) after stent implantation were included in the final analysis. During a mean follow-up of 12.8±1.3 months, the incidence of ISR was 8.6%, which was significantly increased in patients with higher CV of HbA1c (P=0.001). The mean diameter stenosis (DS), net luminal loss and net luminal gain were 22.9±16.8%, 0.42±0.88 mm and 1.66±0.83 mm, respectively. Greater DS was observed in subjects with higher tertiles of CV of HbA1c (P<0.001), and this trend was more prominent in patients with optimal glycemic control (HbA1c≤7%) in the baseline. In multivariate analysis, HbA1c variability was independently associated with incidence of ISR after adjustment for traditional risk factors and mean HbA1c (HR: 3.00 [95% CI:1.14~7.92] for highest vs. lowest tertile). Inclusion of CV of HbA1c led to a better risk stratification accuracy. Assessing HbA1c variability by SD or VIM yielded similar findings. Conclusions: This study suggests that visit-to-visit HbA1c variability is an independent predictor of incidence of ISR in patients with type 2 diabetes after stent implantation.Trial registration: Trials number, NCT02089360; registered on March 17,2014.

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