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Islam P, Schaly S, Abosalha AK, Boyajian J, Thareja R, Ahmad W, Shum-Tim D, Prakash S. Nanotechnology in development of next generation of stent and related medical devices: Current and future aspects. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1941. [PMID: 38528392 DOI: 10.1002/wnan.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 03/27/2024]
Abstract
Coronary stents have saved millions of lives in the last three decades by treating atherosclerosis especially, by preventing plaque protrusion and subsequent aneurysms. They attenuate the vascular SMC proliferation and promote reconstruction of the endothelial bed to ensure superior revascularization. With the evolution of modern stent types, nanotechnology has become an integral part of stent technology. Nanocoating and nanosurface fabrication on metallic and polymeric stents have improved their drug loading capacity as well as other mechanical, physico-chemical, and biological properties. Nanofeatures can mimic the natural nanofeatures of vascular tissue and control drug-delivery. This review will highlight the role of nanotechnology in addressing the challenges of coronary stents and the recent advancements in the field of related medical devices. Different generations of stents carrying nanoparticle-based formulations like liposomes, lipid-polymer hybrid NPs, polymeric micelles, and dendrimers are discussed highlighting their roles in local drug delivery and anti-restenotic properties. Drug nanoparticles like Paclitaxel embedded in metal stents are discussed as a feature of first-generation drug-eluting stents. Customized precision stents ensure safe delivery of nanoparticle-mediated genes or concerted transfer of gene, drug, and/or bioactive molecules like antibodies, gene mimics via nanofabricated stents. Nanotechnology can aid such therapies for drug delivery successfully due to its easy scale-up possibilities. However, limitations of this technology such as their potential cytotoxic effects associated with nanoparticle delivery that can trigger hypersensitivity reactions have also been discussed in this review. This article is categorized under: Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies.
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Affiliation(s)
- Paromita Islam
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Sabrina Schaly
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ahmed Kh Abosalha
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Pharmaceutical Technology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Jacqueline Boyajian
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Rahul Thareja
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Waqar Ahmad
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dominique Shum-Tim
- Division of Cardiac Surgery, Royal Victoria Hospital, McGill University Health Centre, McGill University, Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - Satya Prakash
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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Gunawardena TD, Corballis N, Merinopoulos I, Wickramarachchi U, Reinhold J, Maart C, Sreekumar S, Sawh C, Wistow T, Sarev T, Ryding A, Gilbert TJ, Clark A, Vassiliou VS, Eccleshall S. Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study. J Cardiovasc Dev Dis 2023; 10:jcdd10020084. [PMID: 36826580 PMCID: PMC9963161 DOI: 10.3390/jcdd10020084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
The objective of this study is to compare the outcomes of patients treated with drug-coated balloons (DCBs) or second-generation drug-eluting stents (DESs) for de novo unprotected left main stem (LMS) disease. Previous studies comparing the treatment of LMS disease suggest that the mortality for DES PCI is not worse than CABG. There are limited data from studies investigating the treatment of de novo LMS disease with DCB angioplasty. We compared the all-cause and cardiac mortality of patients treated with paclitaxel DCB to those with second-generation DES for de novo LMS disease from July 2014 to November 2019. Data were analysed using Kaplan-Meier analyses and propensity-matched analyses. A total of 148 patients were treated with either a DCB or DES strategy. There was no significant difference in all-cause mortality in the DCB group (19.5%) compared to the DES group (15.9%) (HR 1.42 [0.61-3.32], p = 0.42). Regarding cardiac mortality, 2 (4.9%) were recorded for the DCB group and 7 (6.5%) for the DES group (HR 1.21 [0.31-4.67], p = 0.786); for target vessel myocardial infarction, there were 0 (0%) for the DCB group and 7 (6.5%) for the DES group; and for target lesion revascularisation, there were 3 (7.3%) in the DCB group and 9 (8.3%) in the DES group (HR: 0.89 [0.24-3.30]). p = 0.86. These remained not significant after propensity score matching. We found no difference in the mortality outcomes with DCB angioplasty compared to second-generation DES, with a median follow-up of 33 months. DCB can therefore be regarded as a safe option in the treatment of LMS disease in suitable patients.
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Affiliation(s)
- Tharusha D. Gunawardena
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Natasha Corballis
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
- Correspondence: (N.C.); (V.S.V.)
| | - Ioannis Merinopoulos
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Upul Wickramarachchi
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Johannes Reinhold
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Clint Maart
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Sulfi Sreekumar
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Chris Sawh
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Trevor Wistow
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Toomas Sarev
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Alisdair Ryding
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Tim J. Gilbert
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Allan Clark
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Vassilios S. Vassiliou
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
- Royal Brompton Hospital, London SW3 6NP, UK
- Correspondence: (N.C.); (V.S.V.)
| | - Simon Eccleshall
- Department of Cardiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
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Gunawardena T, Merinopoulos I, Wickramarachchi U, Vassiliou V, Eccleshall S. Endothelial Dysfunction and Coronary Vasoreactivity - A Review of the History, Physiology, Diagnostic Techniques, and Clinical Relevance. Curr Cardiol Rev 2021; 17:85-100. [PMID: 32552654 PMCID: PMC8142375 DOI: 10.2174/1573403x16666200618161942] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/23/2020] [Accepted: 04/09/2020] [Indexed: 01/08/2023] Open
Abstract
The fervency for advancement and evolution in percutaneous coronary intervention has revolutionised the treatment of coronary artery disease. Historically, the focus of the interventional cardiologist was directed at the restoration of luminal patency of the major epicardial coronary arteries, yet whilst this approach is evolving with much greater utilisation of physiological assessment, it often neglects consideration of the role of the coronary microcirculation, which has been shown to clearly influence prognosis. In this review, we explore the narrative of the coronary circulation as more than just a simple conduit for blood but an organ with functional significance. We review organisation and physiology of the coronary circulation, as well as the current methods and techniques used to examine it. We discuss the studies exploring coronary artery endothelial function, appreciating that coronary artery disease occurs on a spectrum of disorder and that percutaneous coronary intervention has a latent effect on the coronary circulation with long-term consequences. It is concluded that greater recognition of the coronary artery endothelium and mechanisms of the coronary circulation should further guide revascularisation strategies.
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Affiliation(s)
- Tharusha Gunawardena
- Address correspondence to this author at the Department of Cardiology, Norfolk and Norwich University Hospital, Colney Lane NR4 7UY, Norwich, England; E-mail:
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Zhang Y, Zhao J, Yang G, Zhou Y, Gao W, Wu G, Li X, Mao C, Sheng T, Zhou M. Mechanical properties and degradation of drug eluted bioresorbable vascular scaffolds prepared by three-dimensional printing technology. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2019; 30:547-560. [PMID: 30897033 DOI: 10.1080/09205063.2019.1586303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Bioresorbable vascular scaffolds are expected to replace the traditional metal stent, avoiding the long-term complications of metal stents. However, it is hard for the traditional scaffold manufacturing process to meet the requirements of individualized treatment for vascular lesions, which requires different morphologies. Here, we used a new method of scaffold manufacturing, three-dimensional printing technology, to prepare bioresorbable vascular scaffolds. The fabricated scaffold was loaded with sirolimus mixed with scaffold preparation material for slow drug release. The engineered, drug- loaded, bioresorbable vascular scaffold (BVS) was analyzed and tested in vivo. The scaffolds produced by three-dimensional printing technology exhibited good mechanical properties and in vitro degradation performance. The results also suggested that these scaffolds could maintain effective radial strength after long-term degradation and sustained release of the drug. As a new scaffold preparation method, it may provide a promising idea for developing bioresorbable vascular scaffold technology.
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Affiliation(s)
- Yepeng Zhang
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Jie Zhao
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Guangmin Yang
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Yu Zhou
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Wentao Gao
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Guangyan Wu
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Xiaoqiang Li
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
| | - Chun Mao
- b School of Chemistry and National and Local Joint Engineering Research Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Biofunctional Materials Materials Science , Nanjing Normal University , Nanjing , People's Republic of China
| | - Tao Sheng
- c Department of Vascular and Interventional Radiology , Wujin People's Hospital Affilicated to Jiangsu University , Changzhou , People's Republic of China
| | - Min Zhou
- a Department of Vascular Surgery , Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School , Nanjing , People's Republic of China
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Sotomi Y, Onuma Y, Liu S, Asano T, Eggermont J, Katagiri Y, Cavalcante R, de Winter RJ, Wykrzykowska JJ, Brugaletta S, Räber L, Sabaté M, Windecker S, Dijkstra J, Serruys PW. Quality difference of neointima following the implantation of everolimus-eluting bioresorbable scaffolds and metallic stents in patients with ST-elevation myocardial infarction: quantitative assessments by light intensity, light attenuation, and backscatter on optical coherence tomography in the TROFI II trial. EUROINTERVENTION 2018; 14:678-685. [DOI: 10.4244/eij-d-17-00884] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sotomi Y, Suwannasom P, Tenekecioglu E, Collet C, Nakatani S, Okamura T, Muramatsu T, Ishibashi Y, Tateishi H, Miyazaki Y, Asano T, Katagiri Y, von zur Muehlen C, Tanabe K, Kozuma K, Ozaki Y, Serruys PW, Onuma Y. Imaging assessment of bioresorbable vascular scaffolds. Cardiovasc Interv Ther 2017; 33:11-22. [DOI: 10.1007/s12928-017-0486-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
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Sotomi Y, Onuma Y, Collet C, Tenekecioglu E, Virmani R, Kleiman NS, Serruys PW. Bioresorbable Scaffold: The Emerging Reality and Future Directions. Circ Res 2017; 120:1341-1352. [PMID: 28408454 DOI: 10.1161/circresaha.117.310275] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In the era of drug-eluting stents, large-scale randomized trials and all-comer registries have shown excellent clinical results. However, even the latest-generation drug-eluting stent has not managed to address all the limitations of permanent metallic coronary stents, such as the risks of target lesion revascularization, neoatherosclerosis, preclusion of late lumen enlargement, and the lack of reactive vasomotion. Furthermore, the risk of very late stent, although substantially reduced with newer-generation drug-eluting stent, still remains. These problems were anticipated to be solved with the advent of fully biodegradable devices. Fully bioresorbable coronary scaffolds have been designed to function transiently to prevent acute recoil, but have retained the capability to inhibit neointimal proliferation by eluting immunosuppressive drugs. Nevertheless, long-term follow-up data of the leading bioresorbable scaffold (Absorb) are becoming available and have raised a concern about the relatively higher incidence of scaffold thrombosis. To reduce the rate of clinical events, improvements in the device, as well as implantation procedure, are being evaluated. This review will focus on the current CE-mark approved bioresorbable scaffolds, their basic characteristics, and clinical results. In addition, we summarize the current limitations of bioresorbable scaffold and their possible solutions.
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Affiliation(s)
- Yohei Sotomi
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Yoshinobu Onuma
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Carlos Collet
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Erhan Tenekecioglu
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Renu Virmani
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Neal S Kleiman
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Patrick W Serruys
- From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.).
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Sotomi Y, Onuma Y, Dijkstra J, Miyazaki Y, Kozuma K, Tanabe K, Popma JJ, de Winter RJ, Serruys PW, Kimura T. Fate of post-procedural malapposition of everolimus-eluting polymeric bioresorbable scaffold and everolimus-eluting cobalt chromium metallic stent in human coronary arteries: sequential assessment with optical coherence tomography in ABSORB Japan trial. Eur Heart J Cardiovasc Imaging 2017; 19:59-66. [DOI: 10.1093/ehjci/jew329] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/21/2016] [Indexed: 11/14/2022] Open
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Sotomi Y, Onuma Y, Dijkstra J, Eggermont J, Liu S, Tenekecioglu E, Zeng Y, Asano T, de Winter RJ, Popma JJ, Kozuma K, Tanabe K, Serruys PW, Kimura T. Impact of Implantation Technique and Plaque Morphology on Strut Embedment and Scaffold Expansion of Polylactide Bioresorbable Scaffold - Insights From ABSORB Japan Trial. Circ J 2016; 80:2317-2326. [PMID: 27725525 DOI: 10.1253/circj.cj-16-0818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The optimal implantation technique for the bioresorbable scaffold (Absorb, Abbott Vascular) is still a matter of debate. The purpose of the present study was to evaluate the effect of implantation technique on strut embedment and scaffold expansion.Methods and Results:Strut embedment depth and scaffold expansion index assessed by optical coherence tomography (OCT) (minimum scaffold area/reference vessel area) were evaluated in the ABSORB Japan trial (OCT subgroup: 87 lesions) with respect to implantation technique using either quantitative coronary angiography (QCA) or OCT. Strut embedment was assessed at the strut level (n=667), while scaffold expansion was assessed at the lesion level (n=81). The mean embedment depth was 63±59 µm. Balloon sizing and inflation pressure had no direct effect on strut embedment. Plaque morphology affected strut embedment [nonatherosclerotic (58.9±54.3 µm), fibroatheroma (73.3±59.6 µm), fibrous plaque (59.7±51.1 µm), and fibrocalcific plaque (-3.1±61.6 µm, negative value means malapposition), P <0.001]. The balloon-artery ratio positively correlated with the expansion index. This relationship was stronger when the OCT-derived reference vessel diameter (RVD) was used as a reference for balloon selection rather than the QCA-derived one [predilatation (Pearson correlation r: QCA: 0.167 vs. OCT: 0.552), postdilatation (QCA: 0.316 vs. OCT: 0.717)]. CONCLUSIONS Underlying plaque morphology influenced strut embedment, whereas implantation technique had no direct effect on it. Optimal balloon sizing based on OCT-derived RVD might be recommended. However, the safety of such a strategy should be investigated in a prospective trial. (Circ J 2016; 80: 2317-2326).
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Affiliation(s)
- Yohei Sotomi
- Academic Medical Center, University of Amsterdam
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Tenekecioglu E, Bourantas CV, Abdelghani M, Sotomi Y, Suwannasom P, Tateishi H, Onuma Y, Yılmaz M, Serruys PW. Optimisation of percutaneous coronary intervention: indispensables for bioresorbable scaffolds. Expert Rev Cardiovasc Ther 2016; 14:1053-70. [PMID: 27376592 DOI: 10.1080/14779072.2016.1208084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION With new developments in percutaneous coronary intervention (PCI), such as the introduction of bioresorbable scaffolds (BRS), percutaneous treatment of coronary artery diseases has entered a new era. Without metallic remnants, BRSs appear able to overcome several limitations of the existing metallic stents and provide a physiologic treatment of coronary artery pathology. AREAS COVERED BRS have different mechanical properties compared to the traditional metallic stents that should be taken into account during their implantation. Lesion selection, device sizing and satisfied pre-dilatation should be implemented prudently. Although intravascular imaging is not mandatory for the implantation of BRSs it may have a value in optimizing device deployment assess final results and reduce the risk of device related adverse events such as re-stenosis, or scaffold thrombosis. This review aims to reveal the crucial points about the methods of optimization in each steps of BRS implantation. Expert commentary: The target lesions for BRS should be selected meticulously. Pre-dilatation, post-dilatation and intra-vascular imaging techniques should be implemented appropriately to avoid undesirable events after scaffold implantation.
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Affiliation(s)
- Erhan Tenekecioglu
- a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Christos V Bourantas
- b Institute of Cardiovascular Sciences , University College of London , London , UK.,c Department of Cardiology , Barts Health NHS Trust , London , UK
| | - Mohammad Abdelghani
- d Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Yohei Sotomi
- d Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Pannipa Suwannasom
- a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands.,d Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Hiroki Tateishi
- a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Yoshinobu Onuma
- a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Mustafa Yılmaz
- e Department of Cardiology , Bursa Postgraduate Research and Education Hospital , Bursa , Turkey
| | - Patrick W Serruys
- a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands.,f International Centre for Circulatory Health , Imperial College , London , UK
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