Novel treatment approach to ascending aorta pseudoaneurysms: a case report

The pseudoaneurysm of the aorta is rarely due to trauma and infection but usually is a late complication of previous surgical procedures like coronary artery bypass graft surgery. We describe a 65-year-old woman with the pseudoaneurysm of the ascending aorta due to coronary artery bypass graft surgery. It was revealed in coronary artery angiography after nonspecific symptoms. It was confirmed by multidetector computed tomographic angiography. The patient refused open cardiac surgery, so we decided to use an atrial septal defect occluder device in off-label way to seal the pseudoaneurysm orifice. In a hybrid operating room setting, the procedure was done successfully and patient's hospitalization course was eventless. In multidetector computed tomographic angiography after 3 months, the device was in the appropriate position without endoleak and in the yearly visit the patient was asymptomatic and healthy

One-year outcome of everolimus-eluting stents versus biolimus-eluting stents in patients undergoing percutaneous coronary intervention

Background: The biolimus-eluting stent [BES], with a biodegradable polymer, has not been previously compared with the everolimus-eluting stent [EES], as a second-generation drug-eluting stent [DES].We sought to compare the 1-year outcome between the PROMUS[TM] stent [EES type] and the BioMatrix[TM] stent [BES type]

Methods: From March 2008 to September 2011, all patients treated with the PROMUS[TM] stent or the BioMatrix[TM] stent for coronary artery stenosis at Tehran Heart Center were enrolled. The primary end points were 1-year adverse events, comprising death, myocardial infarction, target vessel revascularization, and target lesion revascularization. The secondary end point was stent thrombosis. The Cox proportional hazard model was used to assess the adjusted association between the stent type and the follow-up outcome

Results: From 949 patients [66.3% male, mean age =59.48 +/- 10.46 y] with 1,018 treated lesions, 591 patients [630 lesions, 65.1% male, mean age = 59.24 +/- 10.23 y] received the PROMUS[TM] stent and 358 patients [388 lesions, 68.2% male, mean age = 59.88 +/- 10.83 y] were treated with the BioMatrix[TM] stent. Before adjustment, the rate of the primary end points was 3.2% and 3.4% in the EES and BES, respectively [p value = 0.925, HR [EES to BES] = 1.035, 95% CI: 0.50 to 2.13]. The rate of stent thrombosis was 2% and 1.7% in the EES and BES, respectively [p value = 0.698]. After adjustment on confounder variables, there was no statistically significant difference in major adverse cardiac events between the PROMUS[TM] stent and the BioMatrix[TM] stent [p value = 0.598, HR [EES to BES] = 0.817, 95% CI: 0.39 to 1.73]

Conclusion: At 1 year's follow-up, the BES and EES showed similar safety and efficacy rates in the patients undergoing percutaneous coronary intervention with a relatively low rate of adverse events in the 2 groups