Long-term clinical outcome after implantation of second-generation bare-metal stents

Many clinical studies have been performed to determine the Long-term outcome of coronary Stenting, most of them were based on first-generation bare-metal Stents. This study evaluated long-term [24 +/- 6.4 month] result of second-generation bare metal stents [BMS]. A consecutive series of 128 patients with symptomatic coronary artery disease [CAD] treated electively with second generation bare metal stents between august 2004 and September 2006 was included. Clinical outcome were analyzed after [24 +/- 6.4] months. The Primary end point was based on the occurrence of major adverse cardiac events of MACE [MI, Death, and Repeat Revascularization]. One hundred and forty four bare metal stent were implanted in 134 Vessels. The Mean age of patients was [57 +/- 10.4] years, 72% of patients were male and 352% were diabetic with 98.4% in-hospital success rate. Thirteen [10.3%] patients had MACE during Follow-Up Period [4M1, 3CABG, 2Death and 4R-PCI]. Independent Predictor of MACE was Unstable Angina. Our study showed second generation bare-metal stents is superior to the first one due to better survival rate and lower incidence of MACE

Importância dos estudos pré-clínicos em animais de experimentação para a cardiologia intervencionista: [revisão] / The importance of pre-clinical animal testing in interventional cardiology: [review]

O tratamento da doença cardiovascular mudou radicalmente nas últimas duas décadas, proporcionando aos pacientes uma sobrevida maior e melhor qualidade de vida. Grande parte desse sucesso deve-se à introdução de novas terapias. Em nenhuma outra área essa mudança foi mais evidente do que na cardiologia intervencionista, pois nos últimos vinte anos as intervenções cardiovasculares percutâneas saíram do terreno experimental para formar a base terapêutica dos portadores de doença cardiovascular sintomática. O desenvolvimento dessas tecnologias, desde os primeiros estágios, requer a realização de estudos pré-clínicos com modelos animais. É possível compreender os mecanismos terapêuticos desses dispositivos, uma vez introduzidos na esfera clínica, comparando-se os achados das pesquisas realizadas com modelos animais com amostras de exames anatomopatológicos. Esta análise apresenta uma visão geral do papel emergente dos estudos pré-clínicos, bem como dos resultados, do desenvolvimento e da avaliação de modelos amimais, nas tecnologias de intervenção cardiovascular percutânea para tratamento de pacientes com doença cardiovascular sintomática.

The treatment of cardiovascular disease has changed dramatically over the past 2 decades, allowing patients to live longer and better quality lives. The introduction of new therapies has contributed much to this success. Nowhere has this been more evident than in interventional cardiology, where percutaneous cardiovascular intervention has evolved in the past 2 decades from a quirky experimental procedure to a therapeutic cornerstone for patients with symptomatic cardiovascular disease. The development of these technologies from the earliest stages requires preclinical experiments using animal models. Once introduced into the clinical arena, an understanding of therapeutic mechanisms of these devices can be ascertained through comparisons of animal model research findings with clinical pathological specimens. This review provides an overview of the emerging role, results of preclinical studies and development, and evaluation of animal models for percutaneous cardiovascular intervention technologies for patients with symptomatic cardiovascular disease.

[Stent-ghaft new technique for treatment of aneurysms]

Endovascular aneurysm repair involves the transluminal placement of a graft within the aneurysm that completely excludes the sac from the general circulation, the graft is anchored in place by a balloon-expandable or self-expanding metal frame that supports all or part of the graft and provides a watertight seal proximal and distal to the dilated segment of the artery. Because it avoids the need for laparotomy, cross-clamping of the aorta, and the obligatory blood loss associated with the opening of the aneurysm sac, this technique has much to be recommended. It has the potential to reduce the morbidity and mortality associated with conventional open abdominal aortic aneurysms [AAA] repair and extend the scope of repair to those patients with severe medical co-morbidities who were previously denied treatment

Comparison of carbon ion implanted stent with bare metal stent in patients with coronary artery disease

This study was conducted to evaluate the role of the inert stents in decreasing the incidence of stent restenosis after percutaneous coronary intervention [PCI] and to assess the clinical outcome of these stents. The study comprised 57 patients [49 males and 8 females, mean age 53.3 +/- 0.9 years] with angiographically documented CAD. They were admitted to the Coronary care unit at Benha University Hospital and underwent stent implantation in 57 de novo lesions. Patients were categorized into two groups; group I for whom the traditional bare metal Stainless-steel stents were deployed [30 lesions in 30 pts; 26 M and 4 F with a mean age of 50 yrs], group II for whom Inert stents [carbon [on implanted stents] were deployed [27 lesions in 27 pts; 23 M and 4 F with a mean age of 51 yrs]. Procedural success: was defined as 30% residual stenosis post procedure. Clinical success: was defined as procedural success without the occurrence of MACE [Major Acquired Coronary Events] namely, death, myocardial infarction, or Target vessel revascularization].Clinical follow-up for the occurrence of MACE was performed one and six months after the procedure. Angiographic follow-up was done after six months or after the occurrence of any of the clinical endpoints. Procedural and clinical success were documented in 100% of patients during hospital stay, there was no MACE in both groups. None of patients developed MACE during the 30-days follow-up period. Also, at 6-months follow-up, there was no statistically significant difference between the 2 groups regarding the occurrence of MACE as 4 patients [13.3%] of group I and 3 patients [11.1%] of group II developed MACE. Re-stenosis rate showed also statistically insignificant difference between the 2 groups [5 patients [16.7%] in; group I and 5 [18.5%] patients in group II, [P= > 0.05]. The implantation of Inert stent is safe and feasible, with a high acute procedural success. These stents proved also favorable short term results regarding the thrombotic complication. Inert stent did not add any beneficial effect to the bare metal uncoated stainless-steel stents regarding 6-months in-stent restenosis

Late in-stent restenosis in a patient with drug-eluting stent

Drug coated stents have reduced the incidence of in-stent restenosis with coronary intervention. whether this effect is long lasting or just delaying the process is not clear. We report here a case of late in-stent restenosis with Raoamycin drug eluting stent.