Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice

INTRODUCTION@#Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 µm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD).@*MATERIALS AND METHODS@#This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint.@*RESULTS@#The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis.@*CONCLUSION@#Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation.

Use of Modafi nil for Shortening the Recovery Period of Patients Subjected to Conscious Sedation.

Conscious sedation is a safe and effective technique for patients subjected to invasive diagnostic procedures or minor surgeries. One of the most common seen side effects of this procedure involves Drowsiness, which may be so severe that the patient is not able and advised to resume his normal day to day activities up to 24 h post procedure. This amount of time in recovery is discomforting to the patient and thus should be reduced to a bare minimum following analgesic action of the sedatives. The mechanisms of action of all major classes of sedatives follow a common route via stimulation of gamma amino butyric acid (GABA) receptors along with depression in the release of dopamine, which controls locomotor activity. Modafi nil leads to increase in extracellular and synaptic concentrations of dopamine, elevates hypothalamic histamine levels and also causes activation of glutamatergic circuits, while inhibiting GABAergic neurotransmission. The objective of this short communication was to search for a universal agent to facilitate the recovery post conscious sedation and to determine the role of Modafi nil for the same. At the end, we hypothesized that modafi nil can act as a reliable universal drug to shorten the recovery period of patients subjected to procedural anesthesia.