We compared the three DES groups such as BES, EES, or ZES and matched the difference of baseline characteristics using IPTW analysis. After IPTW, BES showed superior efficacy to EES in reducing total death, cardiac death, TLF, and MACE in AMI patients and similar efficacy to EES or ZES in revascularization and ST.
The management of DAPT in patients with high CV risk is a challenging task, with new data on the subject constantly being reported. Balancing ischaemic benefit with potential bleeding complications adds to the complexity of managing DAPT in these patients. With all the available data and current clinical guidelines, patients deemed at high CV risk should be considered for DAPT, taking into account individual risk:benefit ratio. In most individuals with high CV risk, the net clinical benefit favours the use of DAPT.
Single-cell RNA sequencing analysis identified unique transcriptional changes within regenerated endothelium after plain old balloon angioplasty and stent implantation. These data suggest unique endothelial transcriptional differences, which characterize the different response of the endothelium to vascular injury and may help explain why long-term responses in DES remain suboptimal.
Among patients on DAPT, smoking status and a 2-stent strategy significantly increased the risk of ST, while intracoronary imaging and FKB reduced the isk. In conclusion, age, smoking status, chronic kidney disease and a 2-stent strategy were significant predictors of ST, whereas intracoronary imaging use and FKB had a protective effect. Only smoking status and a 2-stent strategy significantly predicted ST in DAPT subgroup, while intracoronary imaging and FKB had a protective role.
During the catheter-based procedure, the balloon inflates within the artery, while the drug is delivered to the arterial tissue where it is absorbed. The Prevail DCB utilizes a rapid absorption drug – paclitaxel – to enable treatment of de novo lesions, small vessel disease, and in-stent restenosis (ISR). DCB angioplasty does not require a permanent implant and is often used in cases where the implantation of a drug-eluting stent (DES) is not desirable or is technically challenging.
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.
Fucoidan is a polysaccharide largely made up of l-fucose and sulfate groups. Fucoidan is favorable worldwide, especially amongst the food and pharmaceutical industry as a consequence of its promising therapeutic effects. Its applaudable biological functions are ascribed to its unique biological structure. Classical bioactivities associated with fucoidan include anti-oxidant, anti-tumor, anti-coagulant, anti-thrombotic, immunoregulatory, anti-viral and anti-inflammatory effects. More recently, a variety of in vitro and in vivo studies have been carried out to further highlight its therapeutic potentials.
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.
In patients undergoing percutaneous coronary intervention, ultrathin DES improve long term clinical outcomes.
There has been a great evolution in the development of coronary stents in order to avoid both restenosis and thrombosis. Improvements have led to improvements in the design and conformation of metallic or resorbable structures, with an adequate balance between trackability and radial force, the development of antiproliferative drugs and the polymers to control release and allow adequate endothelialisation and an optimal duration of the antiplatelet regimen. Some suggestions are provided about the ideal characteristics of future coronary stents.
Drug-eluting stents (DES) have been widely used for the treatment of cardiovascular diseases. Nevertheless, chronic inflammation and delayed re-endothelialization still represent challenges for their clinical use. In the present work, we developed novel bilayer coatings for stent applications that could overcome these limitations, exclusively using biodegradable plant-based drugs and polymers. In particular, stainless steel surfaces were coated with rutin-loaded zein (the active layer) and cross-linked alginate (the sacrificial layer) via facile dip and spray coating methods.
PCI did not reduce the occurrence of death, reinfarction, or heart failure, and there was a trend toward excess reinfarction during 4 years of follow-up in stable patients with occlusion of the infarct-related artery 3 to 28 days after myocardial infarction.
The second CE Mark has been awarded to MedAlliance for the new Sirolimus Drug Eluting Balloon (DEB), SELUTION SLR 014 PCTA. This is used to treat coronary arterial disease.
In participants with critical limb ischemia, the drug-coated balloon angioplasty group and the conventional percutaneous transluminal angioplasty group had similar primary patency rates at 6 months after treatment of below-the-knee arteries. Amputation-free survival rates through 12 months were higher in the percutaneous transluminal angioplasty group.
More effective and progressively safer generations of drug-elut-ing stents (DES) have replaced bare metal stents (BMS) in rou-tine clinical practice. However, patients considered to be at high bleeding risk (HBR) have traditionally been underrepresented in pivotal DES trials.
リーダー的存在の国際医療機器会社のSINOMEDは本日、アイルランド国立大学ゴールウェイ校（NUI Galway)と協力し、ステンティングの新しい評価法の臨床試験を実施すると発表しました。この試験では、新規特許取得のHT Supreme(R) Healing-Targeted Drug-Eluting Stent (DES)を使います。これは、心臓病患者の治療において新機軸を打ち出す可能性があります。
NUI Galway and leading international medical device company SINOMED have teamed up to conduct a clinical trial of a special stent which has the potential to break new ground in the treatment of patients with heart disease. The PIONEER-IV trial will take place over several years in 30 hospital centres across Europe and involve 2,540 patients. The trial will use the newly patented Healing-Targeted Supreme Stent (HT Supreme™) from SINOMED. The novel drug-eluting stent is designed to encourage rapid healing of the treated blood vessel, thereby potentially reducing reliance on some long-term medications such as blood thinners.
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.
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.
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.
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.
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.
The Serranator percutaneous transluminal angioplasty (PTA) serration balloon catheter is an angioplasty device with serrated metal strips embedded on a semi-compliant balloon. The Serranator’s unique technology is designed to create multiple longitudinal lines of interrupted micro-serrations within the luminal surface to aid in arterial expansion. The result is predictable and controlled lumen gain using low atmospheres of pressure.
Researchers at the Korea Institute of Science and Technology have developed a technique to coat implantable materials, such as stents, with extracellular matrix components and cells. The new approach could lead to implantable devices that suffer fewer adverse events, such as fibrosis, inflammation, and clotting, because of the foreign body response.
The coronary stents, made of our micro metal mesh, are placed in the coronary arteries, into which a bare-metal stent, a drug-eluting stent, a bioabsorbable stent, a dual-therapy stent (combination of both drug and bioengineered stent), or occasionally a covered stent is inserted.
For this, a multilayer-coated balloon catheter, composed of PVP/Drug-loaded liposome/PVP, was suggested. The hydrophilic property of 1st layer, PVP, helps to separate drug layer in hydrophilic blood vessel, and the 2nd layer with Everolimus (EVL)-loaded liposome facilitates drug encapsulation and sustained release to the targeted lesions during inflation time. Additionally, a 3rd layer with PVP can protect the inner layer during transition time for preventing drug loss.