ORIGIN SC is a semi-compliant (SC) PTCA balloon with a very low crossing profile, making it an excellent choice for challenging lesions. ORIGIN SC offers one of the broadest portfolio of sizes available for an SC balloon, including 1.00 mm, 1.25 mm, 1.50 mm and 1.75 mm balloon diameters to treat very small vessels and complex cases.
The potential of CD31 as a therapeutic target in atherosclerosis has been considered ever since its cloning in the 1990s, but the exact role played by this molecule in the biologic events underlying atherosclerosis has remained controversial, resulting in the stalling of any therapeutic perspective. Due to the supposed cell adhesive properties of CD31, specific monoclonal antibodies and recombinant proteins were regarded as blocking agents because their use prevented the arrival of leukocytes at sites of acute inflammation.
Vivasure Medical®, a company pioneering novel fully absorbable technology for percutaneous vessel closure, today announced its development program for PerQseal® Blue, the company’s new investigational product. PerQseal Blue is designed exclusively for sutureless and fully absorbable large-bore venous vessel closure following percutaneous cardiovascular procedures, such transcatheter mitral valve repair or replacement (TMVR) and transcatheter tricuspid valve repair or replacement (TTVR). The PerQseal Blue technology is based on PerQseal, the company’s vascular closure device approved in Europe for use in femoral arteries.
Despite contemporary advances in stent technology, in-stent restenosis (ISR) remains a common issue following percutaneous coronary intervention. A novel classification system based on underlying mechanism of action of restenosis was recently introduced. The Waksman In-Stent Restenosis Classification characterizes different patterns of ISR to best delineate the type of restenosis and help guide treatment. Intravascular imaging with either intravascular ultrasound or optical coherence tomography allows for real-time evaluation of ISR.
The in-silico trial had 82 virtual cases, while the selected traditional clinical trials (PUFS [Pipeline for uncoilable or failed aneurysms], PREMIER [Prospective study on embolisation of intracranial aneurysms with the pipeline device], and ASPIRe [Aneurysm study of pipeline in an observational registry]) featured 109, 141 and 207 patients, respectively. Around half the cases in the traditional trials had high blood pressure.
While there was agreement that it was right to be concerned about the paclitaxel mortality signal raised by Konstantinos Katsanos (Patras, Greece) et al in their December 2018 meta-analysis, there was strong consensus that the evidence is now clear there is no mortality effect when paclitaxel is used in the peripheral arteries. In addition, it was noted that several individual patient-level meta-analyses failed to confirm the high mortality signal flagged by Katsanos and colleagues. There was some discussion surrounding the place of limus as an alternative to paclitaxel, but experts agreed that there is no need to move to another drug—which would have its own set of challenges—given the proven safety and efficacy of paclitaxel. The takeaway message was clear: that, with proper caution and the correct dose, paclitaxel can and should be used in peripheral interventions.
DLyte electropolishing can be used for finishing fragile parts with a wide range of applications from slight deburring to high gloss polishing as the media is non-abrasive and during the process, a high vibration is applied to reduce the friction between the media and the surface. Compared to the liquid electropolishing DLyte is easier to control as it is less aggressive treatment.
Under conditions of hypoxia, most eukaryotic cells can shift their primary metabolic strategy from predominantly mitochondrial respiration towards increased glycolysis to maintain ATP levels. This hypoxia-induced reprogramming of metabolism is key to satisfying cellular energetic requirements during acute hypoxic stress. At a transcriptional level, this metabolic switch can be regulated by several pathways including the hypoxia inducible factor-1α (HIF-1α) which induces an increased expression of glycolytic enzymes.
Endovascular treatment has become first line therapy for the treatment of femoropopliteal disease. Drug-coated devices play a key role in maintaining vessel patency. In the past antiproliferative coating of drug-coated balloons (DCBs) exclusively consisted of paclitaxel. Use of limus drugs was limited by a short residency time in the vessel wall.
The optimal treatment for patients with symptomatic severe intracranial atherosclerotic disease is not well established. Angioplasty and stenting have been attempted, with controversial results, mainly attributed to perioperative complications and a high incidence of restenosis or in-stent restenosis. Drug-coated balloons (DCBs) have shown encouraging results for coronary and peripheral artery disease, without convincing data for intracranial vasculature.
Endovascular treatment (EVT) for symptomatic ICAD treatment has been long debated since the first description of percutaneous transluminal angioplasty in a symptomatic basilar ICAD by Sundt et al in 1980.3 Since the negative SAMMPRIS and VISSIT trials,4 endovascular treatment of symptomatic ICAD—especially percutaneous transluminal angioplasty stenting—has been reluctantly used. Nevertheless, recent results from the WAEVE trial demonstrated a significantly lower periprocedural stroke and death rate of 2.9%,5 which encourages consideration of EVT for symptomatic intracranial atherosclerotic disease.
No specialty in the history of medicine has seen such rapid growth and innovation as interventional cardiology, due to a combination of the compelling need for better results in the treatment of coronary artery disease (CAD), the first cause of death worldwide, and the unique personality of remarkable individuals driving progress.
With experienced interventionalists, and proper patient selection following the on-label usage guidelines, the use of the Wingspan stent for intracranial atherosclerotic disease demonstrated a low periprocedural complication rate and excellent safety profile. This is the largest on-label, multicenter, prospective trial of the Wingspan stent system to date with the lowest reported complication rate.
Although their efficacy and safety have been proved for both in-stent restenosis (ISR) and native small-vessel disease, there are other emerging indications (e.g., bifurcation lesions, large-vessel disease, and high bleeding risk). Because of the recent publication of new randomized clinical trial data, the International DCB Consensus Group is updating its previous recommendations.
Sirolimus has a stronger anti-proliferation effect on atherosclerosis related hypoxic cells than paclitaxel, which may make sirolimus more suitable for the treatment of vascular restenosis. Therapeutic advantage of sirolimus seems related to inhibitions of HIF-1α expression and glycolysis.
In the past decade, tremendous progress has been made in reducing the incidence of restenosis with the advent of the drug-eluting stent (DES). With “plain old balloon angioplasty,” rates of acute and chronic vessel occlusion were unacceptably high at ≈30% to 60%, secondary to acute and chronic recoil and constrictive remodeling. The advent of bare-metal stents (BMS) appeared to eliminate the issue of acute and chronic recoil but introduced a new entity, neointimal hyperplasia (NIH), with classical papers unequivocally demonstrating a strong and linear relationship between NIH formation and late lumen loss (LLL). The restenosis rates with BMS were reported to be between 16% and 44%, with higher rates of stenosis attributable to several risk factors, in particular, long lesion length and small vessel caliber.
Our results confirm that ISR depends on multiple factors, with the ECM dynamics and SMC proliferation the primary contributors to its pathogenesis. In addition to this, the sensitivity analysis carried out for the different model parameters, as well as providing information on the stability of the model, provides us with an understanding of how changes in one parameter will affect the behaviour of the whole system.
In this retrospective, single-center experience, undersized balloon angioplasty followed by Enterprise stent deployment appears technically feasible with a relatively low rate of complications for the treatment of complex symptomatic ICAS. Prospective, multicenter, randomized controlled trials against optimal medical management are warranted.
The SAMMPRIS results do not provide evidence to support the use of PTAS using the Wingspan stent system compared with medical treatment in any examined subpopulation of patients with symptomatic intracranial stenosis, including those with qualifying event hypoperfusion symptoms.
Angioplasty and stenting for symptomatic intracranial atheromatous disease can be performed with the Gateway balloon–Wingspan stent system with a high rate of technical success and acceptable periprocedural morbidity. Our initial experience indicates that this procedure represents a viable treatment option for this patient population.
Stryker’s Wingspan Stent System (Wingspan) is used to open narrowed arteries in the brain of patients diagnosed with intracranial stenosis who are experiencing repeated strokes. Intracranial arterial stenosis, or narrowing of arteries, is a serious condition caused by a buildup of plaque within the intracranial arteries. This may be referred to as intracranial atherosclerotic disease (ICAD). Patients with intracranial stenosis are at serious risk of life-threatening strokes due to reduced blood flow to the brain from narrowed or blocked arteries, and there are few treatment options available for managing this condition.
Restenosis, a narrowing of blood vessels following angioplasty or stent placement is seen in up to 50% of patients. Cases are treated with various options, including drugs, mechanical devices such as stents, genetic treatment such as gene transfer or infusion of stem cells, and combinations of the above.
The event rate remains low over 1 year of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals.
Intracranial artery stenosis is the most common cause of acute ischemic stroke, especially among people in Asia. About its epidemiology, however little is understood. The goal of our research is to establish the prevalence of intracranial artery stenosis in patients with acute ischemic stroke in a tertiary care hospital.
The longer stents, balloon-mounted stents implanted in the intracranial vertebral or basilar artery, and local anesthesia were significantly associated with in-stent restenosis. Further studies are required to identify accurate biomarkers or image markers associated with ISR in ICAS patients.
Intracranial arterial stenosis (ICAS) is currently a major cause of ischemic stroke and affects almost 30% of Chinese patients who have cerebral ischemia1,2; furthermore, patients with symptomatic intracranial atherosclerotic stenosis greater than 70% have a stroke risk of 12.2% per year.
The Global Startup Heat Map below reveals the distribution of the 108 exemplary startups & scaleups we analyzed for this research. Further, it highlights 5 pharma startups that we hand-picked based on criteria such as founding year, location, funding raised, and more. You get to explore the solutions of these 5 startups & scaleups in this report. For insights on the other 103 solutions tackling strokes, get in touch.
The noninferiority of mechanical thrombectomy alone—compared to mechanical thrombectomy plus intravenous tissue plasminogen activator (IV-tPA)—for the treatment of acute ischaemic stroke has been demonstrated across more than 109,000 patients within a national US database. These results were presented at the International Symposium on Endovascular Therapy (ISET; 9–11 May, Miami, USA).