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Chang C, Sung W, Lu Y, Chuang M, Lee Y, Tsai Y, Chou R, Huang S, Huang P. Real-World Clinical Performance of a Novolimus-Eluting Stent Versus a Sirolimus-Eluting Stent. Clin Cardiol 2024; 47:e24317. [PMID: 38953595 PMCID: PMC11217985 DOI: 10.1002/clc.24317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION The DESyne novolimus-eluting coronary stent (NES) is a new-generation drug-eluting stent (DES) that is widely used, but clinical data are rarely reported for this stent. We compared the safety and effectiveness of the DESyne NES and the Orsiro bioresorbable polymer sirolimus-eluting stent (SES) in patients undergoing percutaneous coronary intervention (PCI). METHODS This was a retrospective, single-center, observational study. Between July 2017 and December 2022, patients who presented with chronic or acute coronary syndrome undergoing PCI with DESyne NES or Orsiro SES were consecutively enrolled in the present study. The primary endpoint, major adverse cardiovascular event (MACE), was a composite of cardiovascular death, target-vessel myocardial infarction, or clinically driven target-lesion revascularization. RESULTS A total of 776 patients (age 68.8 ± 12.2; 75.9% male) undergoing PCI were included. Overall, 231 patients with 313 lesions received NES and 545 patients with 846 lesions received SES. During a follow-up duration of 784 ± 522 days, the primary endpoint occurred in 10 patients (4.3%) in the NES group and in 36 patients (6.6%) in the SES group. After multivariate adjustment, the risk of MACE did not significantly differ between groups (NES vs. SES, hazard ratio 0.74, 95% CI, 0.35-1.55, p = 0.425). The event rate of individual components of the primary endpoint was comparable between the two groups. CONCLUSIONS Favorable and similar clinical outcomes were observed in patients undergoing PCI with either NES or SES in a medium-term follow-up duration. Future studies with adequately powered clinical endpoints are required for further evaluation.
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Affiliation(s)
- Chun‐Chin Chang
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Institute of Clinical MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Wei‐Ting Sung
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Ya‐Wen Lu
- Institute of Clinical MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Medicine, Division of CardiologyTaichung Veterans General HospitalTaichungTaiwan
| | - Ming‐Ju Chuang
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Yin‐Hao Lee
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Medicine, Division of CardiologyTaipei City Hospital Yang Ming BranchTaipeiTaiwan
| | - Yi‐Lin Tsai
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Ruey‐Hsing Chou
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Institute of Clinical MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Critical Care MedicineTaipei Veterans General HospitalTaipeiTaiwan
| | - Shao‐Sung Huang
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Healthcare and Services CenterTaipei Veterans General HospitalTaipeiTaiwan
| | - Po‐Hsun Huang
- Department of Medicine, Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Cardiovascular Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Institute of Clinical MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
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Sattar Y, Ullah W, Virk HUH, Doshi R, Rauf H, Desai H, Panchal A, Nasir M, Almas T, Ullah I, Pacha HM, Zaher N, Alraies MC. Coronary intravascular lithotripsy for coronary artery calcifications- systematic review of cases. J Community Hosp Intern Med Perspect 2021; 11:200-205. [PMID: 33889320 PMCID: PMC8043535 DOI: 10.1080/20009666.2021.1883219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Coronary artery calcification (CAC) is a pathological deposition of calcium in the intimal and medial layer of the arterial wall. A plethora of therapeutic calcium debulking techniques is available for the treatment of CAC, including orbital or rotational atherectomy, excimer lasers, cutting, and scoring balloons, which are associated with a soaring rate of complication and low efficacy. To this end, in 2016, the Food and Drug Administration (FDA) posited that shockwave intravascular lithotripsy (S-IVL) technique can be employed with minimal complication. Methods: A retrospective review of cases received lithotripsy for calcified coronary artery disease was performed by using online data from PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The available search results were downloaded into an Endnote library and analyzed into two phases. Results: Out of 24 participants from case reports and series, Majority were found to be Male. There was no significant difference found in the mortality of patients undergoing IVL for the stenosis of the left main stem, left anterior descending, left circumflex artery, or diagonal branch. The mortality was found to be high among 6 patients with prior comorbidities and underwent more than 3 cycles of IVL (OR 37,95% Cl 1.54–886.04, P 0.02). Out of 24 patients, 2 (8.33%) patients developed complications such as vessel dissection (OR 3.4, 95% Cl 17.87–64.68, P 0.4). Conclusion: Shockwave intravascular lithotripsy (S-IVL) may be used in cases of the calcified disease to gain vessel lumen in order to deploy drug-eluting stents with PCI. The success of the DES implantation of IVL can be 100% with a minimal complication rate.
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Affiliation(s)
- Yasar Sattar
- Department of Internal Medicine at Mount Sinai Elmhurst Hospital, New York, NY, USA
| | - Waqas Ullah
- Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA
| | - Hafeez Ul Hasan Virk
- Department of Interventional Cardiology, University Hospitals/Cleveland Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Rajkumar Doshi
- Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA
| | - Hiba Rauf
- Department of Medicine, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Hardik Desai
- Department of Internal Medicine, Gujarat Adani Institute of Medical Sciences, Gujarat, India
| | - Ankur Panchal
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Mubarra Nasir
- Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi, Pakistan
| | - Talal Almas
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Ghandara University, Peshawar, Pakistan
| | - Homam Moussa Pacha
- Department of Cardiology, Memorial Hermann Heart and Vascular Institute, University of Texas, Houston, TX, USA
| | - Nathan Zaher
- Department of Internal Medicine, Wayne State University, Detroit Medical Center, DMC Heart Hospital, Detroit, MI, USA
| | - M Chadi Alraies
- Department of Interventional Cardiology, Detroit Medical Center, Detroit, MI, USA
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Sorini Dini C, Nardi G, Ristalli F, Mattesini A, Hamiti B, Di Mario C. Contemporary Approach to Heavily Calcified Coronary Lesions. Interv Cardiol 2019; 14:154-163. [PMID: 31867062 PMCID: PMC6918474 DOI: 10.15420/icr.2019.19.r1] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/30/2019] [Indexed: 12/17/2022] Open
Abstract
Percutaneous treatment of heavily calcified coronary lesions still represents a challenge for interventional cardiology, with higher risk of immediate complications, late failure due to stent underexpansion and malapposition, and consequently poor clinical outcome. Good characterisation of calcium distribution with multimodal imaging is important to improve the successful treatment of these lesions. The use of traditional or new dedicated devices for the treatment of calcified lesions allows better lesion preparation; therefore, it is important that we know the different mechanisms and technical features of these devices.
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Affiliation(s)
- Carlotta Sorini Dini
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
- Cardiology Division, Spedali RiunitiLivorno, Italy
| | - Giulia Nardi
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
| | - Francesca Ristalli
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
| | - Alessio Mattesini
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
| | - Brunilda Hamiti
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
| | - Carlo Di Mario
- Structural Interventional Cardiology, Careggi University HospitalFlorence, Italy
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Núñez-Gil IJ, Alkhouli M, Centola M, Feltes G, Villablanca P, Ramakrishna H. Analysis of Bioprosthetic Aortic Valve Thrombosis—Implications and Management Strategies. J Cardiothorac Vasc Anesth 2019; 33:2853-2860. [DOI: 10.1053/j.jvca.2018.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Indexed: 01/14/2023]
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