Drug-coated balloon (DCB) angioplasty provides an alternative to drug-eluting stents and plain old balloon angioplasty for the treatment of coronary or peripheral artery disease.The absence of a metallic scaffold with DCB angioplasty compared with stenting might confer a biomechanical and physiological benefit and avoids the implantation of additional stent layers in patients with in-stent restenosis.Several randomized clinical trials have been performed comparing DCB angioplasty with a variety of comparators in both coronary and peripheral artery disease, although more evidence is needed, particularly in de novo coronary artery disease.

Patients at high ischemic or bleeding risk after percutaneous coronary intervention (PCI) require protection against thrombotic events with dual antiplatelet therapy (DAPT) while avoiding bleeding. Although guidelines recommend 12-month DAPT after acute coronary syndrome (ACS), recent trials have tested the safety of early aspirin withdrawal with potent P2Y12-inhibitor monotherapy.

In patients with acute coronary syndromes, the rate of cardiac death, myocardial infarction, or target lesion revascularization was not different 5 years after TiNO-coated stent or after EES implantation.

Stent thrombosis (ST) is a catastrophic event and efforts to reduce its incidence by altering blood-stent interactions are longstanding. A new electret coating technology that produces long-lasting negative charge on stent surface could make them intrinsically resistant to thrombosis. We assessed the thrombogenicity of stents using an annular perfusion model with confocal microscopy, and determined the efficacy of electret coating technology to confer thrombo-resistant properties to standard stents. Using an annular perfusion chamber, Bare Metal Stent (BMS), standard uncoated DES (DES), and Electret-coated DES (e-DES) were exposed to human blood under arterial flow conditions. Deposits of fibrinogen and platelets on the stent surface were analyzed using immunofluorescence staining and confocal microscopy. Surface coverage by fibrinogen and platelets and the deposit/aggregate size were quantified using computerized morphometric analysis.

PCL and PLGA coatings on Mg-based alloy stents were studied by EIS. PCL coating significantly improves corrosion resistance; PLGA coating maintains it. Dielectric properties of the coatings were well characterized by the Young model. Polymer coating protection is limited by cracks formed when the stent is deployed. Evaluation of stent corrosion resistance must consider mechanical effects when the stent is deployed. 

The current debate in cardiology centers on the use of drug-eluting balloons (DEBs) vs drug-eluting stents (DESs) in de novo lesions. However, to reach this conclusion, it must be shown that the balloon is superior to the stent, the standard treatment in patients presenting with acute myocardial infarction. A recent study concluded that in patients with diffuse de novo coronary artery disease, intervention with a balloon was associated with a significant reduction in major adverse cardiovascular events compared with intervention with a stent.

Airiver Medical, a clinical stage company developing technologies to help patients who suffer from certain respiratory tract conditions, was granted designation as a Breakthrough Device from the U.S. Food and Drug Administration (FDA) for its Airiver Pulmonary Drug Coated Balloon (DCB) to treat central airway stenosis.The FDA Center for Devices and Radiological Health (CDRH) granted Airiver Medical the Breakthrough Device Designation to expedite development of its Pulmonary Drug Coated Balloon (DCB) for patient access because it has a reasonable chance of providing more effective treatment or diagnosis of life-threatening or irreversibly debilitating human disease or conditions than the current standard of care.

Obstructive coronary disease remains a leading cause of sudden cardiac death (SCD). The management of SCD therefore involves coronary angiography. Our aim was to evaluate whether the non-hyperemic angiography-derived microcirculatory resistance index (NH-IMRangio) could be an easy-to-use tool for identifying patients with electrical heart disease (EHD) from patients with other causes of SCD.

As per international guidelines, coronary lesions are primarily treated with drug-eluting stents (DESs). While DESs have demonstrated good clinical outcomes, even the latest generations remain associated with restenosis, vessel thrombosis, and myocardial infarction (MI), investigators state in a press release. In addition, DES carry an intrinsic thrombotic risk, requiring dual antiplatelet therapy (DAPT). However, elderly patients and those at high bleeding risk (HBR) have a cumulative increase in adverse events, including a higher thrombotic risk after angioplasty with DES.

The available evidence supports the optimization of medical therapy as the first-line therapeutic approach for most patients with non-acute myocardial ischaemic syndromes.Physicians should carefully consider selected patients who might benefit from invasive therapy with percutaneous coronary intervention or coronary artery bypass graft surgery.Patients with persistent symptoms who are unable to tolerate up-titration of medications might be candidates for early percutaneous coronary intervention to improve symptoms, especially for non-complex coronary artery disease.Selecting appropriate high-risk patients who would benefit from coronary artery bypass graft surgery continues to be supported by the evidence for improved event-free survival.

According to VERITAS Study data, 93.9% of non-valvular AFib patients implanted with the Amulet 360 achieved full closure of the LAA by 45 days, with no leaks over 3mm. The LAA is a small pouch linked to increased stroke risk in AFib patients. The device is minimally invasive and adapts to each patient’s unique LAA shape, providing immediate closure and potentially reducing the need for blood-thinning medication where suitable.

Despite guideline recommendations, evidence for the use of non–vitamin K antagonist oral anticoagulant (NOAC) monotherapy in patients with atrial fibrillation after implantation of a drug-eluting stent remains limited.

For coating peripheral stents with anti-restenosis drug/polymer solutions. Sono-Tek is well known for providing uniform coatings onto specialty and custom stents with targeted coverage and no webbing. 

Shanghai Yangmi's ultrasonic spraying technology allows for coating thickness deviations within ±5% after deposition onto medical device surfaces. This is particularly suitable for full-coverage coating of complex-shaped medical devices (such as porous stents and threaded implants). It also prevents problems such as solution sedimentation, agglomeration, and uneven atomization during the spraying process.

At first glance, the platelet is a simple cell. However, its small size hides an extremely well conserved structure that is vital for its function in both hemostasis and vascular integrity and development. A combination of electron microscopy, light microscopy, biochemical, and cell biology studies has, over the years, revealed this structure to us and allowed the important functions of the various organelles and subcellular components to be understood. This chapter reviews the structure of the resting platelet and discusses the dramatic and dynamic changes, especially in the cytoskeleton, that occur upon activation to allow platelets to carry out their primary function in hemostasis.

Inflammation plays a significant role in the pathogenesis of atherosclerosis as evidenced by the data of preclinical studies and large epidemiological trials. The pathophysiological association between inflammation and atherosclerosis is very complex and many mediators are included. The most important mediators of this association are the cytokines and, specifically, IL-1β and IL-6 chemokines, IFN-γ, and TNF-α. Large randomized clinical studies and meta-analyses have shown that anti-inflammatory therapies have a favorable efficacy profile and can reduce the hazard of cardiovascular events. However, the results of randomized trials of therapies specifically targeting inflammation are controversial, and, therefore, further studies are needed to elucidate this association in the future.

Patients who have residual inflammation following acute coronary syndromes (ACSs) are at high risk of further major adverse cardiovascular events (MACEs). Canakinumab and colchicine are anti-inflammatory agents that target the innate immune system and have been shown to reduce MACEs in patients with chronic coronary artery disease. In the ACS population, the evidence for colchicine reducing MACEs has been less robust, with recent data showing that it was ineffective in ACSs. Furthermore, both agents have significant side effects. An unmet clinical need therefore exists to identify a well-tolerated drug that regulates the immune system and effectively reduces residual inflammation in ACSs.

Effective, durable options to address faltering dialysis access circuits have remained elusive, leaving a significant unmet need in long-term access maintenance. Until now. Promising interim data have emerged from the prospective, multicentre DEScover trial evaluating the Solaris DE sirolimus-eluting, electrospun polytetrafluoroethylene (PTFE) covered stent for the treatment of failed access circuits, drawing high hopes from leading global vascular specialists that a transformational solution might finally be at hand. “We have never had a drug-eluting platform that directly addressed the issue of edge restenosis, which is where most of these types of devices fail, when they fail,” says Peter Schneider (University of California San Francisco, San Francisco, USA). “This is where the Solaris DE platform will have a big impact—it will be a one-of-a-kind.”

Inherent to any stenting procedure is the prescription of dual antiplatelet therapy (DAPT) to reduce the platelet response. Clinical guidelines recommend 6–12 months of DAPT, depending on stent type, clinical picture and patient factors. Our hypothesis is that a nanostructured noble metal coating has the potential to reduce protein deposition and platelet activation. These effects would reduce subsequent thrombo-inflammatory reactions, potentially mitigating the need for an extensive DAPT in the acute phase. Here, a noble metal nanostructure coating on stents is investigated. Twelve pigs underwent endovascular implantation of coated and non-coated stents for paired comparisons in a blinded study design.

Effective, durable options to address faltering dialysis access circuits have remained elusive, leaving a significant unmet need in long-term access maintenance. Until now. Promising interim data have emerged from the prospective, multicentre DEScover trial evaluating the Solaris DE sirolimus-eluting, electrospun polytetrafluoroethylene (PTFE) covered stent for the treatment of failed access circuits, drawing high hopes from leading global vascular specialists that a transformational solution might finally be at hand. “We have never had a drug-eluting platform that directly addressed the issue of edge restenosis, which is where most of these types of devices fail, when they fail,” says Peter Schneider (University of California San Francisco, San Francisco, USA). “This is where the Solaris DE platform will have a big impact—it will be a one-of-a-kind.”