ABSTRACT
Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention (PCI) of de-novo coronary artery lesion by using Bioabsorbable Vascular Scaffold (BVS) ABSORB stents eluting Everolimus. Methods: Total 16 patients were enrolled in this very preliminary study of BVS absorb. Among them, Male: 11 and Female: 5. Total 20 stents were deployed. Mean age were for Male: 56 yrs, for Female: 60 yrs. Associated coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history (FH) for CAD and Smoking. Patients were followed up clinically. Results: Among the study group; 13 (81%) were Dyslipidemic, 10(62.5%) were hypertensive; 6 (37.5%) patients were Diabetic, FH 3(18.75%), and 2(18%) were all male smoker. Female patients were more obese [Body Mass Index (BMI) M 25: F 27] and developed CAD in advance age. A common stented territory was for left anterior descending artery (LAD): 6 (37.5%), left circumflex artery (LCX) 5 (25%), right coronary artery (RCA) 6(37.5%). One patient had both LCX and LAD stenting. Total 3 patients had double/overlapping stent in RCA lesion. Territory wise distributions of BVS ABSORB stent were for LAD 6(30%), RCA 9 (45%), and LCX 5 (25%). There was no periprocedural or postprocedural complication. Conclusion: BVS ABSORB Everolimus eluting vascular scaffold showed favorable clinical outcome without any major cardiac events (acute or late stent thrombosis, MI or death) over a period of 9 month. Thus, BVS ABSORB would be favorable alternative to other available drug eluting metallic stents.
ABSTRACT
Background: Coronary artery disease (CAD) in Bangladeshi population is diffuse in nature with small caliber arteries. Now a day, these are treated, by PCI with stent deployment, often multiple in a single coronary artery. However, long term data on In-stent re-stenosis (ISR) in multiple or overlapping stent in single coronary artery in these patients is not yet available. Therefore, the aim of our present study was to assess long-term outcome of stent patency or the development of ISR of varieties stent in single vessel territory. Methods: Patients were prospectively selected from, who underwent coronary angiogram at our hospital for further evaluation of their previous PTCA in the 3-36 months preceding the study for the quantifying period of 2007-2011. Total 51 patients (male: 42, Female: 9) who had multiple stents in one coronary artery were included in this study. Average age was Male: 57; Female:61. Average study period was 3.1 ± 2.4yrs. Results: Our results show that, among the total studied population 82.4% (42) were male and 17.6% (9) were female. Total 114 stent were deployed in 54 vessels of 51 patients. Territory wise distribution of deployed stent was LAD 52(45.6%), RCA 42 (36.8%) and LCX 20(17.5%). Stent used were BMS 45(39.5%), DES 69(60.5%). Re-look Coronary Angiogram (CAG) revealed that Significant ISR (ISR>60%) developed in BMS 8(17.8%) and DES 8(11.5%). Among the different DES the development of significant ISR were in Sirolimus 1(3.2%), Paclitaxel 4(16%), Everolimus 3 (30%). Conclusion: Our study has shown that deployment of multiple stents in a single artery territory (either separately or as overlapping) is safe and has reasonably lower degree of ISR, even when BMS was used. As a whole BMS shows higher degree of ISR than to DES for an average period of follow up of 3.1 yrs.
ABSTRACT
Background: Aim of the study was to assess the safety of the trans-radial Percutaneous coronary intervention (PCI) than conventional Trans-femoral approach by using either Bare-metal stents (BMS) and or Drug Eluting Stent (DES) like Sirolimus-eluting or Paclitaxel-eluting stent. Also to see its safety in regards of procedural time, quick mobilization, less complication and less radiation exposure. Methods: Total 117 patients were randomized from a total of 538 patients who had PCI at our center in the quantifying period. Total 130 stent deployed in 117 patients. Among the patients, Male: 100 and Female:17 . Mean age were for Male: 55yrs, for Female:57yrs . Associated Coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive FH for CAD and Smoking (all male). Results: Our study shows 21.7% had trans-radial PCI. Among the study group; 72 (61.5%) were Dyslipidemic, 75 (64.1%) were hypertensive: 47(40.2%) patients were Diabetic, FH 29 (24.8%) and 33(33%) were all male smoker. Female patients were more obese (BMI M 27: F 29) and developed CAD in advance age. Common stented territory were LAD 51 (43.6%) followed by RCA 41 (35%) and LCX 27(23%). Average length and diameter of stented vessel were almost same in all territory. Territory wise multiple or overlapping stenting was done in LAD 3 (6 stents), RCA 1(2stents), LCX 4 (10 stents). Stent used: BMS 37 (28.5%), Sirolimus 41(31.5%), Paclitaxel 27 (21%), Everolimus 22 (16.9%), Biolimus 2 (1.5%) and Zotarolimus 1(0.75%). Less Procedural time, reduced radiation exposure, no procedural complication and overall better patient comfort were observed. Conclusion: Our study has revealed that trans-radial PCI is safe with reduced radiation exposure, quick mobilization of patient and no procedural complication in all the case, indicates it can be done routinely as an alternative to conventional Trans-femoral approach.
ABSTRACT
Background: Data of stent patency or the development of ISR in multiple or overlapping stent in a single vessel territory of Bangladeshi diabetic (DM) patient population is not yet available. Therefore, the aim of our present study was to assess primarily the long-term stent patency of varieties of stent in patient with Diabetes Mellitus (DM) and Non-diabetes Mellitus (NDM). Methods: Patients were prospectively selected from, who underwent coronary angiogram at our hospital for further evaluation of their previous PTCA in the e”36 months preceding the study for the quantifying period of 2007-2011. Total 51 (11%) patients (male: 41, Female: 10) from a total 461 patients were included in this study who has multiple or overlapping stent in single vessel territory. Total 32 (62.7%) patients included into the DM group with an average age of 57 yrs and in the NDM were 19 (37.3%) with 58 yrs. Average ISR period was 3.1 ± 2.4 yrs. Results: Our result shows that total 70 stent were deployed in 33 vessels of DM patient and 44 stent in 21 vessel of Non-DM patient. Territory wise total number of deployed stent in patient of DM: NDM were in LAD 34 (48.6%): 18(41%), RCA 16 (22.8%): 4 (9%) and LCX 20(28.6%): 22(55%). Stent used in DM: NDM; were BMS 21 (30%): 22(50%), Sirolimus 24(34.3%): 10(22.7%), Paclitaxel 17(24.3%):8(18.2%), Everolimus 6(8.6%):4(9.1%)%). Re-look coronary angiogram (CAG) revealed that increased number of in-stent restenosis occurred more in patient with Diabetes [DM 10(31.3%) vs NDM 5(26.3%)]. Significant ISR (ISR>60%) in DM patient treated with for BMS were 4 (36.4%), for Paclitaxel 3(42.3%), for Sirolimus 1(9.1%). Average stent size and length were almost same in both groups for any coronary territory. Conclusion: Our study has revealed that increased number of ISR were more in patient with diabetes (DM) in a single artery territory when multiple stents were used either separately or as overlapping. Among the stent used, Sirolimus shows better patency with reduced ISR than Paclitaxel and other limus eluting stent for an average period of follow up of 3.1 yrs.