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Cortese B, Kalkat H, Bathia G, Basavarajaiah S. The evolution and revolution of drug coated balloons in coronary angioplasty: An up-to-date review of literature data. Catheter Cardiovasc Interv 2023; 102:1069-1077. [PMID: 37870079 DOI: 10.1002/ccd.30891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/30/2023] [Indexed: 10/24/2023]
Abstract
European Society of Cardiology (ESC) guidelines gave class I A indication for use of DCB in in-stent restenosis. However, no indication exists for the usage of DCB in de novo lesions. Although the current generation DES offer excellent results, as we embark more complex lesions such as calcified lesion and chronic total occlusion, restenosis and stent thrombosis are higher and tend to increase within the years. There is increasing desire to leave nothing behind to abolish the risk of restenosis and stent thrombosis and hence the absorbable scaffolds were introduced, but with disappointing results. In addition, they take several years to be absorbed. Drug coated balloons offer an alternative to stents with no permanent implant of metal or polymer. They are already in use in in Europe and Asia and they have been approved for the first time in the United States for clinical trials specifically for restenotic lesions. There is emerging data in de novo lesions which have shown that DCB are noninferior and in some studies maybe even superior to current generation DES especially in small vessels. In this article, we provide a comprehensive review of the literature on this expanding technology focussing on the evidence in both re-stenotic and de novo lesions.
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Affiliation(s)
- Bernardo Cortese
- Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy
- DCB Academy, Milano, Italy
- Cardioparc, Lyon, France
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2
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Mohamad T, Jyotsna F, Farooq U, Fatima A, Kar I, Khuwaja S, Memon UA, Kumari V, Puri P, Aslam ZM, Elder Z, Varrassi G, Paladini A, Khatri M, Kumar S, Muzammil MA. Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors. Cureus 2023; 15:e43977. [PMID: 37746355 PMCID: PMC10516147 DOI: 10.7759/cureus.43977] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
The field of cardiovascular medicine is undergoing a transformative shift towards personalized medicinal therapy, particularly in the context of post stent implantation. This narrative review explores the significance, challenges, and future directions of individualized treatment strategies for patients with coronary stents. The review highlights the pivotal role of personalized approaches in optimizing treatment efficacy and minimizing adverse events. Real-world clinical studies and trials underscore the importance of tailoring antiplatelet therapy based on platelet function testing, genetic testing, and risk scoring. These studies reveal that personalized medicinal treatment improves clinical outcomes by balancing preventing thrombotic events and mitigating bleeding risks. Challenges, including cost, test availability, patient adherence, and ethical considerations, are discussed in depth, shedding light on the complexities of implementing personalized approaches. Technological advancements, including omics data integration, artificial intelligence, and big data analytics, shape the future of personalized medicinal therapy. These tools enable precise pharmacogenomic selection of medications and the development of integrated risk-scoring systems. Patient engagement and education are also central, with empowered patients and remote monitoring contributing to collaborative decision-making. In conclusion, the narrative review underscores that personalized medicinal therapy post stent implantation holds immense promise for revolutionizing cardiovascular care. By embracing a comprehensive approach that considers genetics, clinical factors, and patient preferences, healthcare providers can optimize treatment outcomes and improve patient quality of life. The evolving landscape of personalized medicine offers a glimpse into a future where tailored treatment strategies become the cornerstone of precision cardiovascular care.
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Affiliation(s)
| | - Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND
| | - Umer Farooq
- Medicine, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Aroob Fatima
- Medicine, Ejaz Sikandar Memorial Hospital, Kanganpur, PAK
| | - Indrani Kar
- Medicine, Lady Hardinge Medical College, New Delhi, IND
| | - Sundal Khuwaja
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Unaib Ahmed Memon
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Versha Kumari
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Piyush Puri
- Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | - Zaid M Aslam
- Internal Medicine, Ziauddin University, Karachi, PAK
| | - Zachary Elder
- Medical Education, American University of the Caribbean School of Medicine, Cupecoy, SXM
| | | | - Antonella Paladini
- Department of MESVA (Life, Health, and Environmental Sciences), University of L'Aquila, L'Aquila, ITA
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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Sareło P, Sobieszczańska B, Wysokińska E, Gąsior-Głogowska M, Kałas W, Podbielska H, Wawrzyńska M, Kopaczyńska M. In vitro examinations of the anti-inflammatory interleukin functionalized polydopamine based biomaterial as a potential coating for cardiovascular stents. Biocybern Biomed Eng 2023. [DOI: 10.1016/j.bbe.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Characterizing the Mechanical Performance of a Bare-Metal Stent with an Auxetic Cell Geometry. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study develops and characterizes the distinctive mechanical features of a stainless-steel metal stent with a tailored structure. A high-precision femtosecond laser was used to micromachine a stent with re-entrant hexagonal (auxetic) cell geometry. We then characterized its mechanical behavior under various mechanical loadings using in vitro experiments and through finite element analysis. The stent properties, such as the higher capability of the stent to bear upon bending, exceptional advantage at elevated levels of twisting angles, and proper buckling, all ensured a preserved opening to maintain the blood flow. The outcomes of this preliminary study present a potential design for a stent with improved physiologically relevant mechanical conditions such as longitudinal contraction, radial strength, and migration of the stent.
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Josyula A, Parikh KS, Pitha I, Ensign LM. Engineering biomaterials to prevent post-operative infection and fibrosis. Drug Deliv Transl Res 2021; 11:1675-1688. [PMID: 33710589 PMCID: PMC8238864 DOI: 10.1007/s13346-021-00955-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
Implantable biomaterials are essential surgical devices, extending and improving the quality of life of millions of people globally. Advances in materials science, manufacturing, and in our understanding of the biological response to medical device implantation over several decades have resulted in improved safety and functionality of biomaterials. However, post-operative infection and immune responses remain significant challenges that interfere with biomaterial functionality and host healing processes. The objectives of this review is to provide an overview of the biology of post-operative infection and the physiological response to implanted biomaterials and to discuss emerging strategies utilizing local drug delivery and surface modification to improve the long-term safety and efficacy of biomaterials.
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Affiliation(s)
- Aditya Josyula
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Kunal S Parikh
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Center for Bioengineering Innovation and Design, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Ian Pitha
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Laura M Ensign
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA.
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, 21287, USA.
- Departments Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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Pacharra S, McMahon S, Duffy P, Basnett P, Yu W, Seisel S, Stervbo U, Babel N, Roy I, Viebahn R, Wang W, Salber J. Cytocompatibility Evaluation of a Novel Series of PEG-Functionalized Lactide-Caprolactone Copolymer Biomaterials for Cardiovascular Applications. Front Bioeng Biotechnol 2020; 8:991. [PMID: 32903548 PMCID: PMC7438451 DOI: 10.3389/fbioe.2020.00991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/29/2020] [Indexed: 11/24/2022] Open
Abstract
Although the use of bioresorbable materials in stent production is thought to improve long-term safety compared to their durable counterparts, a recent FDA report on the 2-year follow-up of the first FDA-approved bioresorbable vascular stent showed an increased occurrence of major adverse cardiac events and thrombosis in comparison to the metallic control. In order to overcome the issues of first generation bioresorbable polymers, a series of polyethylene glycol-functionalized poly-L-lactide-co-ε-caprolactone copolymers with varying lactide-to-caprolactone content is developed using a novel one-step PEG-functionalization and copolymerization strategy. This approach represents a new facile way toward surface enhancement for cellular interaction, which is shown by screening these materials regarding their cyto- and hemocompatibility in terms of cytotoxicity, hemolysis, platelet adhesion, leucocyte activation and endothelial cell adhesion. By varying the lactide-to-caprolactone polymer composition, it is possible to gradually affect endothelial and platelet adhesion which allows fine-tuning of the biological response based on polymer chemistry. All polymers developed were non-cytotoxic, had acceptable leucocyte activation levels and presented non-hemolytic (<2% hemolysis rate) behavior except for PLCL-PEG 55:45 which presented hemolysis rate of 2.5% ± 0.5. Water contact angles were reduced in the polymers containing PEG functionalization (PLLA-PEG: 69.8° ± 2.3, PCL-PEG: 61.2° ± 7.5) versus those without (PLLA: 79.5° ± 3.2, PCL: 76.4° ± 10.2) while the materials PCL-PEG550, PLCL-PEG550 90:10 and PLCL-PEG550 70:30 demonstrated best endothelial cell adhesion. PLLA-PEG550 and PLCL-PEG550 70:30 presented as best candidates for cardiovascular implant use from a cytocompatibility perspective across the spectrum of testing completed. Altogether, these polymers are excellent innovative materials suited for an application in stent manufacture due to the ease in translation of this one-step synthesis strategy to device production and their excellent in vitro cyto- and hemocompatibility.
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Affiliation(s)
- Sandra Pacharra
- Salber Laboratory, Centre for Clinical Research, Department of Experimental Surgery, Ruhr-Universität Bochum, Bochum, Germany
| | - Seán McMahon
- Laboratory A, Synergy Centre, Ashland Specialties Ireland Ltd., Dublin, Ireland
| | - Patrick Duffy
- Laboratory A, Synergy Centre, Ashland Specialties Ireland Ltd., Dublin, Ireland
| | - Pooja Basnett
- School of Life Sciences, College of Liberal Arts and Sciences, University of Westminster, London, United Kingdom
| | - Wenfa Yu
- Rosenhahn Group, Faculty of Chemistry and Biochemistry, Analytical Chemistry - Biointerfaces, Ruhr-Universität Bochum, Bochum, Germany
| | - Sabine Seisel
- Faculty of Chemistry and Biochemistry, Analytical Chemistry - Center for Electrochemical Sciences, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrik Stervbo
- Centre for Translational Medicine, Medical Department I, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany
| | - Nina Babel
- Centre for Translational Medicine, Medical Department I, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany
| | - Ipsita Roy
- Roy Group, Kroto Innovation Centre, Department of Materials Science and Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Richard Viebahn
- Department of Surgery, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Germany
| | - Wenxin Wang
- The Charles Institute of Dermatology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Jochen Salber
- Salber Laboratory, Centre for Clinical Research, Department of Experimental Surgery, Ruhr-Universität Bochum, Bochum, Germany.,Department of Surgery, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Germany
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Tang F, Liu M, Zeng O, Tan W, Long J, Liu S, Yang J, Chu C. Gefitinib-coated balloon inhibits the excessive hyperplasia of intima after vascular injuries through PI3K/AKT pathway. Technol Health Care 2020; 27:331-343. [PMID: 31045551 PMCID: PMC6598000 DOI: 10.3233/thc-199031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To explore the effect of gefitinib-coated balloon suppressive action on the excessive hyperplasia of intima after balloon injury of common carotid artery in rats and on the PI3K/AKT signal pathway. METHODS MTT method and the expression of Bcl-2 and Caspase-3 proteins were detected in vitro; Adult SD rats were randomly split into 5 groups, namely sham group, model group, low-dosage gefitinib-coated balloon group, high-dosage gefitinib-coated balloon group, and paclitaxel-coated balloon group. The intimal proliferation of arteries, PCNA, P-AKT and PI3K protein expression, the cell apoptosis, expression of MMP9, TGFβ and IL6 mRNA were measured by hematoxylin and eosin (H&E) staining, immunohistochemistry, TUNEL staining, and RT-qPCR. RESULTS At the same time and concentration, Gefitinib suppressed the proliferation of smooth muscle cell more significantly than paclitaxel. Bcl-2 and Caspase-3 in vascular smooth muscle and endothelial cells (VSMC, EC) were significantly down-regulated and up-regulated after the cells were treated with gefitinib and paclitaxel. In gefitinib- and paclitaxel-coated balloon groups, significant up-regulations were found in the area of lumen. Furthermore, the expression of PCNA suggested that all coated balloons could suppress the excessive proliferation of smooth muscle cells in the hyperplastic intima compared with the control group. In gefitinib- and paclitaxel-coated balloon group, the expression of PI3K/AKT was significantly down-regulated. The use of drug-coated balloons mitigated the cell apoptosis in TUNEL. The expressions of MMP9, TGFβ and IL6 mRNA in the model group were obviously up-regulated; and they were obviously down-regulated in the high-dose gefitinib-coated balloon group compared with the model group. CONCLUSIONS Gefitinib-coated balloons were able to suppress the excessive proliferation in the common carotid arterial intima of rats more effectively than the paclitaxel-coated ones. The underlying mechanism may cover the PI3K/AKT signal pathway.
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Affiliation(s)
- Fen Tang
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Maojun Liu
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Ou Zeng
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Wenting Tan
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | | | - Shengquan Liu
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Jun Yang
- Department of Cardiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Chun Chu
- Department of Pharmacy, the Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
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Biocompatible Polymer Materials with Antimicrobial Properties for Preparation of Stents. NANOMATERIALS 2019; 9:nano9111548. [PMID: 31683612 PMCID: PMC6915381 DOI: 10.3390/nano9111548] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/15/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022]
Abstract
Biodegradable polymers are promising materials for use in medical applications such as stents. Their properties are comparable to commercially available resistant metal and polymeric stents, which have several major problems, such as stent migration and stent clogging due to microbial biofilm. Consequently, conventional stents have to be removed operatively from the patient's body, which presents a number of complications and can also endanger the patient's life. Biodegradable stents disintegrate into basic substances that decompose in the human body, and no surgery is required. This review focuses on the specific use of stents in the human body, the problems of microbial biofilm, and possibilities of preventing microbial growth by modifying polymers with antimicrobial agents.
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Hu A, Huang J, Li S, Gao Y, Wu L, Deng J, Liu J, Gong Q, Li L, Xu S. Involvement of stromal cell-derived factor-1α (SDF-1α), stem cell factor (SCF), fractalkine (FKN) and VEGF in TSG protection against intimal hyperplasia in rat balloon injury. Biomed Pharmacother 2019; 110:887-894. [DOI: 10.1016/j.biopha.2018.12.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 01/17/2023] Open
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Doshi R, Shah J, Jauhar V, Decter D, Jauhar R, Meraj P. Comparison of drug eluting stents (DESs) and bare metal stents (BMSs) with STEMI: who received BMS in the era of 2nd generation DES? Heart Lung 2018; 47:231-236. [PMID: 29544863 DOI: 10.1016/j.hrtlng.2018.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/09/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to analyze the indications for using bare metal stents (BMSs) in hospitalizations with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS The study cohorts were identified from the National Inpatient Sample database from 2010-2014 using appropriate, International Classification of Diseases, 9th Revision, Clinical Modification, diagnostic and procedural codes. RESULTS A total of 123,487 hospitalizations were identified for this study. Drug eluting stent (DES) use demonstrated lower in-hospital mortality (5.8% vs. 3.3%, P = < 0.01) and other in-hospital outcomes, thus resulting in lower hospitalization stay. Higher age, black race, greater comorbidity burden, inferior wall myocardial infarction, and the use of mechanical circulatory devices were all associated with BMS use. CONCLUSION DES was the preferred standard of care in the era of 2nd generation DES; however, BMSs were used in hospitalizations with high-risk procedures and multiple risk factors.
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Affiliation(s)
- Rajkumar Doshi
- Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York.
| | - Jay Shah
- Department of Internal Medicine, Mercy Saint Vincent Hospital, University of Toledo, Toledo, OH
| | - Varun Jauhar
- Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Dean Decter
- Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Rajiv Jauhar
- Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Perwaiz Meraj
- Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York
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Doshi R, Singh A, Jauhar R, Meraj PM. Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2018; 8:369-378. [DOI: 10.1177/2048872617745790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The interventional treatment of complex high-risk indicated patients is technically difficult and can result in poor outcomes. Thus, percutaneous left ventricular assist devices are being increasingly used to provide hemodynamic support. No data is available comparing male and female for Complex High-risk Indicated Patients treated with percutaneous left ventricular assist devices. Our goal was to evaluate in-hospital as well as short term outcomes comparing males and females. Methods: There were 160 complex high-risk indicated patients with percutaneous left ventricular assist device use who were not in cardiogenic shock. A total of 132 male and 28 female patients were included. Ejection fraction below 35% with one additional criterion such as use of atherectomy device or treatment on unprotected left main disease or multi-vessel disease were our inclusion criteria. An Impella 2.5 or Impella CP (Abiomed Inc.) device was used as a left ventricular support device. Results: There was no difference in in-hospital mortality between the genders after performing a propensity score matched analysis (8.3% vs. 12.5%, p=0.54). Secondary outcomes of myocardial infarction, cardiogenic shock, congestive heart failure, dysrhythmia, major adverse cardiac events and composite of all complications were higher in males. Furthermore, 30-day survival was similar in males and females (88.9% vs. 87.5%, p=0.31). In addition, worse complications rates and survival were noted in patients with incomplete revascularization compared with those patients with complete revascularization in both gender. Conclusion: This study demonstrated no gender difference in clinical outcomes when using percutaneous left ventricular assist device support for the treatment of complex high-risk indicated patients. Overall, males had higher secondary outcomes compared with females with no difference in in-hospital mortality or 30-day survival rates.
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Affiliation(s)
- Rajkumar Doshi
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Avneet Singh
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Rajiv Jauhar
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Perwaiz M Meraj
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
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Han CM, Park KS, Joung YK. Recent alternative approaches of vascular drug-eluting stents. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2017. [DOI: 10.1007/s40005-017-0378-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Chung CJ, Green P. Atherosclerotic Cardiovascular Disease in Older Adults. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0225-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bito K, Hasebe T, Maegawa S, Maeda T, Matsumoto T, Suzuki T, Hotta A. In vitrobasic fibroblast growth factor (bFGF) delivery using an antithrombogenic 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer coated with a micropatterned diamond-like carbon (DLC) film. J Biomed Mater Res A 2017; 105:3384-3391. [DOI: 10.1002/jbm.a.36201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/09/2017] [Accepted: 08/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Kenta Bito
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
| | - Terumitsu Hasebe
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
- Department of Radiology; Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-cho; Hachioji-shi Tokyo 192-0032 Japan
| | - Shunto Maegawa
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
| | - Tomoki Maeda
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
| | - Tomohiro Matsumoto
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
- Department of Radiology; Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-cho; Hachioji-shi Tokyo 192-0032 Japan
| | - Tetsuya Suzuki
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
| | - Atsushi Hotta
- Department of Mechanical Engineering; Keio University, 3-14-1 Hiyoshi; Kohoku-ku Yokohama 223-8522 Japan
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Denby KJ, Clark DE, Markham LW. Management of Kawasaki disease in adults. Heart 2017; 103:1760-1769. [DOI: 10.1136/heartjnl-2017-311774] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/09/2017] [Accepted: 05/15/2017] [Indexed: 12/26/2022] Open
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The combined use of Drug-eluting balloon and Excimer laser for coronary artery Restenosis In-Stent Treatment: The DERIST study. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2017; 18:165-168. [DOI: 10.1016/j.carrev.2016.12.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/07/2016] [Accepted: 12/14/2016] [Indexed: 11/19/2022]
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A review of the coronary applications of the drug coated balloon. Int J Cardiol 2017; 226:77-86. [DOI: 10.1016/j.ijcard.2016.09.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 09/07/2016] [Accepted: 09/15/2016] [Indexed: 11/22/2022]
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Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention after Kawasaki Disease: The Pediatric Canadian Series. Pediatr Cardiol 2017; 38:36-43. [PMID: 27663723 DOI: 10.1007/s00246-016-1480-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/15/2016] [Indexed: 10/21/2022]
Abstract
Coronary artery (CA) aneurysms are serious complications of Kawasaki disease (KD) responsible for ischemic events. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are reported with limited data on indications and comparative efficacy. Retrospective multicenter comparison of CA intervention following KD is performed in this study. Twenty two cases were available from 5 centers, of whom 11 underwent CABG, 10 PCI and 1 systemic thrombolysis. Age at intervention (8.3 ± 3.9 vs 11.3 ± 4.9 years, p = 0.14) and interval from diagnosis (5.6 ± 4.1 vs 6.5 ± 4.7 years, p = 0.64) were similar between CABG and PCI. Interventions were based on angiography in 15 patients or cardiac event in 7, with no difference between CABG and PCI (p = 0.24). Patients with CABG were more likely to undergo multivessel intervention (73 vs 10 %, p = 0.006). None of the patients needed reintervention after CABG, compared to 6 after PCI and 1 after systemic thrombolysis (p = 0.004). Signs of ischemia on stress testing or MIBI were present in 15 patients before intervention and persisted in 9 patients following last intervention, in a significantly higher proportion after CABG than PCI (80 vs 17 %, p = 0.01). In this series, CABG, which mostly involved multivessel intervention, was superior to PCI. Nevertheless, larger-scale studies may help define patient selection criteria for a beneficial PCI approach.
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