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Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction. Coron Artery Dis 2022; 33:196-205. [PMID: 34985003 DOI: 10.1097/mca.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the difference in early vascular healing between the ultrathin-strut biodegradable-polymer sirolimus-eluting Orsiro stent (O-SES) and the polymer-free biolimus-A9-eluting BioFreedom stent (BF-BES), assessed with optical coherence tomography (OCT) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarctions (STEMIs). METHODS Eighty patients with STEMI who underwent primary PCI were randomly allocated 1:1 to treatment with BF-BES or O-SES. OCT was acquired after PCI and at 1-month follow-up. The primary endpoint was 1-month OCT-assessed vascular healing index based on the presence of uncovered and malapposed stent struts and intraluminal filling defects where low vascular healing index indicated favorable vascular healing. RESULTS At 1-month, the vascular healing index was similar in O-SES 11.5 [interquartile range (IQR) 9.5-17.5], compared to BF-BES 11.5 (IQR 7.1-12.5; P = 0.14). Percentage of uncovered struts [O-SES 31.5% (IQR 20.7-41.9), P = 0.43] vs. BF-BES 27.8% (IQR 19.4-41.9; P = 0.44), and median volume of neointimal hyperplasia [O-SES 4.9 mm3 (IQR 1.4-13.1) vs. BF-BES 7.1 mm3 (IQR 2.8-17.0), P = 0.18] did not differ significantly between the two stent groups. Complete coverage was not observed in any of the stents. The percentages of stents with malapposition did not differ significantly (O-SES 87.1% vs. BF-BES 71.4%, P = 0.14) whereas percentage of malapposed struts [O-SES 3.5% (IQR 0.8-5.5) vs. BF-BES 0.8% (IQR 0.0-1.8), P = 0.003] was lower in the BF-BES group. CONCLUSION In patients with STEMI, the drug-coated BF-BES and the thin strut O-SES had similar vascular healing index at 1-month. However, the thin O-SES struts were more often malapposed.
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Golino M, Nuzzo S, Briguori C. STENTYS coronary system: current status and future direction. Minerva Cardiol Angiol 2020; 69:201-214. [PMID: 32989961 DOI: 10.23736/s2724-5683.20.05167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stentys self-apposing stent was designed to face complex lesions in the precincts of percutaneous coronary interventions. Nitinol platform and disconnectable struts were designed to provide a complete apposition on the vessel wall in challenging lesions such as significant tapering, primary angioplasty in ST segment elevation myocardial infarction and bifurcation. Stentys X-position S is a sirolimus eluting stent with a novel delivery system aiming to improve positioning. Clinical trials showed good results in terms of procedural success rate, clinical outcome and short-term strut apposition. Nevertheless, Stentys stent did not show superiority over the conventional balloon-expandable stents in the clinical outcomes. Authors underlined the importance of a learning curve and an adequate training period to get familiar with the device's features. Future trials in an all-comer population using the novel X-Position S stent will confirm the preliminary findings and strengthen evidence in clinical practice.
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Affiliation(s)
- Marco Golino
- Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy
| | | | - Carlo Briguori
- Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy -
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Jiang J, Tian NL, Cui HB, Li CL, Liu XB, Dong L, Sun Y, Chen XM, Chen SL, Xu B, Wang JA. Post-dilatation improves stent apposition in patients with ST-segment elevation myocardial infarction receiving primary percutaneous intervention: A multicenter, randomized controlled trial using optical coherence tomography. World J Emerg Med 2020; 11:87-92. [PMID: 32076473 DOI: 10.5847/wjem.j.1920-8642.2020.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction (STEMI). This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention (pPCI) for acute STEMI. METHODS The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation. Patients were randomly assigned to control group (n=20) or post-dilatation group (n=21) in which a non-compliant balloon was inflated to >16 atm pressure. Strut apposition and coverage were evaluated by optical coherence tomography (OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up. The primary endpoint was rate of incomplete strut apposition (ISA) at 7 months after pPCI. RESULTS There were similar baseline characteristics except for stent length (21.9 [SD 6.5] mm vs. 26.0 [SD 5.8] mm, respectively, P=0.03). In post-dilatation vs. control group, ISA rate was lower (2.5% vs. 4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate (95.2% vs. 95.0%, P>0.05) or corrected TIMI frame counts (22.6±9.4 vs. 22.0±9.7, P>0.05); and at 7-month follow-up (0.7% vs. 1.8%, P<0.0001), the primary study endpoint, with similar strut coverage (98.5% vs. 98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events (MACE). CONCLUSION In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate. Larger and longer term studies are warranted to further assess safety (ClinicalTrials.gov identifier: NCT02121223).
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Affiliation(s)
- Jun Jiang
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Nai-Liang Tian
- Department of Cardiology, Nanjing First Hospital, Nanjing, China
| | - Han-Bin Cui
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
| | - Chang-Ling Li
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Liang Dong
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yong Sun
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Min Chen
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
| | - Shao-Liang Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Pellegrini D, Cortese B. Focus on STENTYS ® Xposition S Self-Apposing ® stent: a review of available literature. Future Cardiol 2019; 15:145-159. [PMID: 31023079 DOI: 10.2217/fca-2018-0087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Percutaneous coronary interventions are the primary revascularization strategy for the vast majority of patients with coronary artery disease. Nevertheless, challenging settings still limit optimal results, especially in case of significant tapering, bifurcations or primary angioplasty in ST-segment elevation myocardial infarction. Stentys® Self-Apposing® stent was designed to improve strut apposition to the vessel wall and to adapt to difficult targets. The Xposition S is a sirolimus-eluting stent with a novel delivery system, to improve accurate positioning. Several studies compared the device with traditional balloon-expandable stents, showing better results in terms of malapposition reduction and a noninferiority in relation to procedural outcomes. Available data show good clinical results, but a direct comparison with balloon-expandable stents from large randomized trials is still lacking. Thus, the Stentys Xposition S can be an alternative to traditional stents in dedicated scenarios, but strong evidence from large randomized trials is needed to derive stronger recommendations.
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Affiliation(s)
- Dario Pellegrini
- Department of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Bernardo Cortese
- Department of Cardiac, San Carlo Clinic, Via Leonardo da Vinci, Paderno Dugnano, Milano, Italy
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Lu H, De Winter RJ, Koch KT. The STENTYS self-apposing stent technology in coronary artery disease: literature review and future directions. Expert Rev Med Devices 2018; 15:479-487. [DOI: 10.1080/17434440.2018.1491305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Huangling Lu
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Robbert J. De Winter
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Karel T. Koch
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Fate of Different Types of Intrastent Tissue Protrusion. JACC Cardiovasc Interv 2018; 11:95-97. [DOI: 10.1016/j.jcin.2017.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/10/2017] [Indexed: 11/21/2022]
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Long-term clinical outcome after implantation of the self-expandable STENTYS stent in a large, multicenter cohort. Coron Artery Dis 2017; 28:588-596. [DOI: 10.1097/mca.0000000000000533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Wiktor DM, Waldo SW, Armstrong EJ. Coronary Stent Failure: Fracture, Compression, Recoil, and Prolapse. Interv Cardiol Clin 2017; 5:405-414. [PMID: 28582037 DOI: 10.1016/j.iccl.2016.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Current-generation coronary drug-eluting stents are associated with low rates of restenosis and target lesion revascularization. However, several mechanisms of stent failure remain clinically important. Stent fracture may occur in areas of excessive torsion or angulation. Longitudinal stent deformation is related to axial stent compression owing to extrinsic forces or secondary devices that disrupt stent architecture. Stent recoil occurs when a stent does not deploy at its optimal cross-sectional area. Tissue prolapse between stent struts may also predispose patients to adverse outcomes. Prevention, recognition, and treatment of these stent failures are necessary to optimize patient outcomes after percutaneous coronary interventions.
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Affiliation(s)
- Dominik M Wiktor
- Division of Cardiology, VA Eastern Colorado Healthcare System, University of Colorado, Denver, CO, USA
| | - Stephen W Waldo
- Division of Cardiology, VA Eastern Colorado Healthcare System, University of Colorado, Denver, CO, USA
| | - Ehrin J Armstrong
- Division of Cardiology, VA Eastern Colorado Healthcare System, University of Colorado, Denver, CO, USA.
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Andreasen LN, Holm NR, Balleby IR, Krusell LR, Maeng M, Jakobsen L, Veien KT, Hansen KN, Kristensen SD, Hjort J, Kaltoft A, Dijkstra J, Terkelsen CJ, Lassen JF, Madsen M, Bøtker HE, Jensen LO, Christiansen EH. Randomized comparison of sirolimus eluting, and biolimus eluting bioresorbable polymer stents: the SORT-OUT VII optical coherence tomography study. Eur Heart J Cardiovasc Imaging 2017; 19:329-338. [DOI: 10.1093/ehjci/jex035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/16/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lene N Andreasen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Niels R Holm
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Ida R Balleby
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Lars R Krusell
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Lars Jakobsen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Karsten T Veien
- Department of Cardiology, Odense University Hospital, Søndre Boulevard 29, 5000 Odense C, Odense, Denmark
| | - Knud N Hansen
- Department of Cardiology, Odense University Hospital, Søndre Boulevard 29, 5000 Odense C, Odense, Denmark
| | - Steen D Kristensen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Jakob Hjort
- Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark
| | - Anne Kaltoft
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Jouke Dijkstra
- Division of Image Processing, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Christian J Terkelsen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Jens F Lassen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Morten Madsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
| | - Lisette O Jensen
- Department of Cardiology, Odense University Hospital, Søndre Boulevard 29, 5000 Odense C, Odense, Denmark
| | - Evald H Christiansen
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200 Aarhus N, Skejby, Denmark, Denmark
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Harbaoui B, Emsellem P, Cassar E, Besnard C, Dauphin R, Motreff P, Courand PY, Lantelme P. Primary angioplasty: Effect of deferred stenting on stent size. Arch Cardiovasc Dis 2017; 110:206-213. [PMID: 28139456 DOI: 10.1016/j.acvd.2016.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/22/2016] [Accepted: 09/13/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Primary angioplasty with immediate stenting (IS) is the gold standard for ST-segment elevation myocardial infarction (STEMI). Deferred stenting (DS) has been proposed to limit periprocedural complications, and may influence stent size because of thrombus and spasm alleviation. AIM We sought to study the effect of DS on stent size. METHODS Over the study period, 258 patients underwent primary angioplasty for STEMI (DS, n=84; IS, n=174). An informative coronary angiogram run - i.e. allowing for proper lesion analysis - was selected and anonymized by an independent operator. Two experienced operators randomly analysed these runs, and proposed stent dimensions after having measured vessel diameter and lesion length by quantitative coronary analysis. The primary objective was the variation in stent size between the two coronary angiograms. RESULTS The median delay between the two coronary angiograms was 2 days. Overall, the stent length was shorter (-1.64mm; P=0.030) and its diameter was larger (+0.13mm; P<0.001) during the second coronary angiogram, especially in the right coronary arteries. CONCLUSIONS DS led to the implantation of a larger and shorter stent; this is probably because DS allows for more accurate assessment of the residual lesion after relief of spasm and thrombus, and may have clinical consequences in terms of stent thrombosis and restenosis.
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Affiliation(s)
- Brahim Harbaoui
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude-Bernard Lyon 1, Hospices Civils de Lyon, 69100 Lyon, France
| | - Philippe Emsellem
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Emmanuel Cassar
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Cyril Besnard
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Raphael Dauphin
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Pascal Motreff
- Université d'Auvergne, Cardio-Vascular Interventional Therapy and Imaging, Image Science for Interventional Techniques, UMR 6284, 63000 Clermont-Ferrand, France; University Hospital of Clermont-Ferrand, Cardiology Department, 63000 Clermont-Ferrand, France
| | - Pierre-Yves Courand
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude-Bernard Lyon 1, Hospices Civils de Lyon, 69100 Lyon, France
| | - Pierre Lantelme
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude-Bernard Lyon 1, Hospices Civils de Lyon, 69100 Lyon, France.
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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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When the culprit was the collateral-donor vessel and infarct related artery was the collateral-recipient vessel: PCI of the victim CTO vessel with Stentys Xposition S. Int J Cardiol 2016; 207:89-91. [PMID: 26797338 DOI: 10.1016/j.ijcard.2016.01.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/06/2016] [Indexed: 11/21/2022]
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de la Torre Hernandez JM. Balloon-expandable vs. self-expanding stents: new insights into a renewed debate. EUROINTERVENTION 2015; 11:852-4. [DOI: 10.4244/eijv11i8a174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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