Recent Advances in Stent Technology: Do They Reduce Cardiovascular Events? Oct. 3, 2022, 1:32 p.m.
DES are essential for the management of patients with obstructive coronary artery disease and are used in most coronary interventions. Changes in stent designs over the past 30 years reflect the ongoing need to address the limitations of earlier stents aimed to improve patient outcomes.
Plaque characteristics in patients with ST-segment elevation myocardial infarction and early spontaneous reperfusion Oct. 3, 2022, 10:18 a.m.
This prospective study enrolled a total of 241 consecutive patients with STEMI undergoing optical coherence tomography (OCT) from July 2016 to August 2019. Forty-five patients (18.7%) met angiographic ESR criteria (TIMI 3 flow on the initial angiogram). Among those without ESR (TIMI 0 flow on initial angiogram), 45 patients were assigned to the control group according to propensity score matching with the ESR group.
Application of Current Guidelines to the Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction Oct. 3, 2022, 10:06 a.m.
There is a growing body of evidence to support the substitution of the low-molecular-weight heparin (LMWH) enoxaparin for unfractionated heparin (UFH). Three recent trials have demonstrated the benefit of an early invasive strategy with catheterization followed by revascularization in patients at high and intermediate risk. Lower-risk patients should undergo early noninvasive stress testing. An intensive program of secondary prevention is mandatory and should be begun before hospital discharge.
Recent Advances in Manufacturing Innovative Stents Oct. 3, 2022, 10:01 a.m.
Cardiovascular diseases are the most distributed cause of death worldwide. Stenting of arteries as a percutaneous transluminal angioplasty procedure became a promising minimally invasive therapy based on re-opening narrowed arteries by stent insertion. In order to improve and optimize this method, many research groups are focusing on designing new or improving existent stents. Since the beginning of the stent development in 1986, starting with bare-metal stents (BMS), these devices have been continuously enhanced by applying new materials, developing stent coatings based on inorganic and organic compounds including drugs, nanoparticles or biological components such as genes and cells, as well as adapting stent designs with different fabrication technologies. Drug eluting stents (DES) have been developed to overcome the main shortcomings of BMS or coated stents.
SMART-CHOICE 3-Year Outcomes Assistance Dropping Aspirin After PCI Oct. 3, 2022, 9:44 a.m.
The SMART-CHOICE trial compared 2 antiplatelet techniques– 3 months of DAPT followed by long-lasting P2Y12 inhibitor monotherapy (primarily with clopidogrel) or extended DAPT for 12 months or longer– in 2993 clients who had actually gone through PCI with a drug-eluting stent. Outcomes at 12 months revealed a comparable rate of ischemic occasions with both techniques however a lower rate of bleeding in the group that got reduced DAPT. The SMART-CHOICE private investigators now report the 3-year outcomes revealing comparable results.At 3 years, the main endpoint, a composite of all-cause death, myocardial infarction (MI), or stroke, had actually taken place in 6.3% of the reduced DAPT group and 6.1% in the extended DAPT group, providing a risk ratio of 1.06 (95% CI, 0.79– 1.44).
Safety and efficacy of drug coated balloon angioplasty for intracranial atherosclerotic disease Sept. 30, 2022, 4:08 p.m.
After treatment with DCB angioplasty, complications were no different from those after standard balloon angioplasty or stenting. This study suggests that DCB angioplasty may be a safe and effective procedure for intracranial arterial stenosis.
Enrolment completed in trial comparing PCI in diabetic patients Sept. 30, 2022, 9:48 a.m.
ABILITY DIABETES-GLOBAL, a randomised controlled head-to-head trial comparing safety and efficacy of percutaneous coronary intervention with the sirolimus-eluting Abluminus DES+ (Concept Medical) to Xience (Abbott) in patients with diabetes mellitus has completed enrolment.
World Heart Day Sept. 29, 2022, 8:16 a.m.
World Heart Day is a great time to promote heart health and make better choices for the future. Learn more about food, exercises to improve heart health.
Culprit lesion location and outcomes in patients with multivessel disease and infarct-related cardiogenic shock: a core laboratory analysis of the CULPRIT-SHOCK trial Sept. 26, 2022, 10:01 a.m.
Among multivessel disease patients with acute myocardial infarction-related cardiogenic shock, critical culprit lesion location (LM, LM equivalent, proximal LAD or last remaining vessel) is independently associated with 30-day and one-year mortality. Critical culprit lesion location is a major prognostic marker, immediately available in multivessel disease patients with myocardial infarction-related cardiogenic shock.
POST-PCI raises red flags for routine functional testing in high-risk PCI patients Sept. 26, 2022, 9:59 a.m.
Routine stress testing was associated with more invasive coronary angiography and repeat revascularization after 1-year without a significant reduction in major cardiovascular events or mortality,” he said. “Our trial does not support active surveillance with routine functional testing as a follow-up strategy in high-risk patients undergoing PCI.
Advanced NanoTherapies’ SirPlux Duo Balloon Gets Breakthrough Device Nod Sept. 26, 2022, 9:55 a.m.
Advanced NanoTherapies has received the FDA’s Breakthrough Device designation for its SirPlux Duo drug-coated balloon for treatment of coronary artery disease in vessels smaller than 3.0mm. The device delivers a combination treatment of sirolimus and paclitaxel in a low-dose, long-term release for stent-like expansion and to prevent renarrowing.
Mood, Personality, and Behavior Changes During Treatment with Statins: A Case Series Sept. 26, 2022, 9:53 a.m.
These observations support the potential for adverse mood and behavioral change in some individuals with statin use, extend the limited literature on such effects, and provide impetus for further investigation into these presumptive ADRs. Potential mechanisms are reviewed, including hypothesized mechanisms related to oxidative stress and bioenergetics.
Calcified In-Stent Restenosis Sept. 25, 2022, 2:44 p.m.
The acute results of repeated interventions for patients with in-stent restenosis (ISR) are largely satisfactory, although some patients may still have recurrences. In this anatomic scenario, lack of initial angiographic success is exceedingly rare. We report a patient with “undilatable” ISR that eventually required rotational atherectomy to achieve procedural success. Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) unraveled the presence of severely calcified intrastent tissue, leading to “resistant” ISR.
Health Care Monitoring and Treatment for Coronary Artery Diseases Sept. 25, 2022, 2:10 p.m.
In-stent restenosis concerning the coronary artery refers to the blood clotting-caused re-narrowing of the blocked section of the artery, which is opened using a stent. The failure rate for stents is in the range of 10% to 15%, where they do not remain open, thereby leading to about 40% of the patients with stent implantations requiring repeat procedure within one year, despite increased risk factors and the administration of expensive medicines. Hence, today stent restenosis is a significant cause of deaths globally. Monitoring and treatment matter a lot when it comes to early diagnosis and treatment.
Enabling Angioplasty‐Ready “Smart” Stents to Detect In‐Stent Restenosis and Occlusion Sept. 25, 2022, 1:52 p.m.
Despite the multitude of stents implanted annually worldwide, the most common complication called in-stent restenosis still poses a significant risk to patients. Here, a “smart” stent equipped with microscale sensors and wireless interface is developed to enable continuous monitoring of restenosis through the implanted stent. This electrically active stent functions as a radiofrequency wireless pressure transducer to track local hemodynamic changes upon a renarrowing condition.
Super high-pressure balloon versus scoring balloon to prepare severely calcified coronary lesions: the ISAR-CALC randomised trial Sept. 24, 2022, 3:53 p.m.
In patients with severely calcified coronary artery lesions, preparation with a super high-pressure balloon versus a scoring balloon was associated with comparable stent expansion on intravascular imaging and a trend towards improved angiographic performance.
MagicTouch SCB receives IDE approval for In-Stent Restenosis indication Sept. 21, 2022, 9:18 a.m.
US FDA's IDE approval allows the MagicTouch SCB to be used in a pivotal clinical study to support safety and effectiveness of this combination product. The data generated from this IDE clinical study will support a pre-market approval (PMA) application in the USA. MagicTouch SCB is the world's first Sirolimus-coated Balloon with extensive commercial usage in Europe, major markets of Asia and the Mid-Eastern markets. More than 100 thousand patients have been treated with MagicTouch SCB in these markets.
Angiographic Quantitative Flow Ratio-Guided Coronary Intervention: Two-Year Outcomes of the FAVOR III China Trial Sept. 20, 2022, 2:27 p.m.
QFR-guided lesion selection improved 2-year clinical outcomes compared with standard angiography guidance. The benefits were most pronounced among patients in whom QFR assessment altered the planned revascularization strategy.
FAVOR III China: Angiographic quantitative flow ratio-guided coronary intervention - a multicentre, randomised, sham-controlled trial Sept. 20, 2022, 2:26 p.m.
A note of caution when interpreting the results, current QFR technology requires acquisition of two angiographic images separated by >25° for each lesion with no significant vessel tortuosity or overlap, with current technology QFR may not be feasible in up to 20% of cases. Accuracy and reproducibility of QFR is dependent on technique and angiographic quality. Overall the patients enrolled had low anatomical complexity (mean SYNTAX Scores QFR 9.3±6.0 vs. Angio 9.6±6.3) therefore the results may not be generalisable to a higher risk population.
Challenges of the newer generation of Resorbable magnesium scaffolds: Lessons from failure mechanisms of the past generation Sept. 20, 2022, 12:33 p.m.
Bioresorbable scaffolds (BRS) using magnesium alloy are still under development. Current magnesium BRS seems to be promising regarding the risk of thrombosis. Remaining issue is if the BRSs can provide sufficient radial force over a long time