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Recurrent drug-eluting stent restenosis (DES ISR) can be challenging to treat. Vascular brachytherapy (VBT) has been used with encouraging results. We report the long-term outcomes of patients with recurrent DES ISR treated with VBT from January 2014 to September 2018 [target lesion failure (TLF)

Drug-coated balloons (DCBs) constitute one of the therapeutic tools used in percutaneous coronary interventions (PCIs) of both stent restenosis and "de novo" coronary lesions, mainly in bifurcations and small vessels. Diabetic patients represent an unfavorable subgroup because of their higher

Drug coated balloons (DCB) currently constitute one of the therapeutic tools used in percutaneous coronary interventions(PCI) of both stent restenosis and "de novo" coronary lesions, mainly in bifurcations and small vessels. Nowadays, their results at a long-term follow up are unclear. The main

With increased complexity of percutaneous coronary intervention stent failure remains a concern and requires continued surveillance. Stent restenosis, thrombosis and fracture have been reported as time-dependent determinants of stent failure. The aim of the current study was therefore to explore the

Objectives The aim of this study was to determine the mechanisms and predictors of carotid artery restenosis after carotid artery stenting (CAS) using serial intravascular ultrasound (IVUS) imaging. Background Carotid artery stenting is increasingly used to treat high-grade obstructive carotid disease, but our knowledge of carotid in-stent restenosis and remodeling remains limited. Methods Post-procedural and 6-month (median 6 months) follow-up quantitative carotid angiography and IVUS were performed after self-expanding stent deployment in 50 internal carotid arteries (ICA). The IVUS measurements at multiple designated sites included minimal luminal diameter, lumen area, stent area (SA), and neointimal hyperplasia area (NIH). Results Late stent enlargement at follow-up was found at all segments, and the percentage increase was greatest at the ICA lesion site (mean ± SD, 48.9 ± 35.3%). The NIH, expressed as a percentage of SA, was seen within all segments of the stent and was greatest at the ICA lesion site (37.3 ± 23.3%). There was a strong positive correlation between the amount of NIH and late stent enlargement (r = 0.64; p Conclusions Although self-expanding carotid stents generate considerable neointimal hyperplasia, the process is balanced by marked late stent enlargement. Small stent dimensions immediately post-procedure were associated with a higher risk of restenosis.

ObjectivesWe evaluated the long-term influence of intramural delivery of advanced c-myc neutrally charged antisense oligonucleotides (Resten-NG) on neointimal hyperplasia after stenting in a pig model.BackgroundNeointimal hyperplasia after percutaneous coronary interventions is one of the key components of the restenotic process. The c-myc is a critical cell division cycle protein involved in the formation of neointima.MethodsIn short-term experiments, different doses (from 500 μg to 5 mg) of Resten-NG or saline were delivered to the stent implantation site with an infiltrator delivery system (Interventional Technologies, San Diego, California). Animals were euthanized at 2, 6 and 18 h after interventions, and excised vessels were analyzed for c-myc expression by Western blot. In long-term experiments, either saline or a dose of 1, 5 or 10 mg of Resten-NG was delivered in the same fashion, and animals were euthanized at 28 days after the intervention.ResultsWestern blot analysis demonstrated inhibition of c-myc expression and was dose dependent. Morphometry showed that the intimal area was 3.88 ± 1.04 mm2in the control. There was statistically significant reduction of intimal areas in the 5 and 10 mg groups (2.01 ± 0.66 and 1.95 ± 0.91, respectively, p < 0.001) but no significant reduction in the 1 mg group (2.81 ± 0.56, p > 0.5) in comparison with control.ConclusionsThis study demonstrated that intramural delivery of advanced c-myc neutrally charged antisense morpholino compound completely inhibits c-myc expression and dramatically reduces neointimal formation in a dose dependent fashion in a porcine coronary stent restenosis model, while allowing for complete vascular healing.

Introduction: Durable polymer drug eluting stent (DEP) has endothelial anti-proliferative properties that can decrease stent restenosis rates. We sought to compare the safety and efficacy of BEP to DEP for treatment of ACS. Methods: Pub Med and Chochrane database were searched using all RCT's that

We read with interest the publication of RIBS IV (Restenosis Intra-stent of Bare Metal Stents: Paclitaxel-eluting Balloon vs Everolimus-eluting Stent) trial by Alfonso et al. [(1)][1], questioning the role of drug-coated balloons (DCB) in the treatment of drug-eluting stent restenosis (DES-ISR).

The journey taken for treatment of in-stent restenosis (ISR) began similarly to and then diverged markedly from the path traveled for de novo lesions. Similar to de novo lesions, balloon angioplasty initially demonstrated safety and moderate success rates for treatment of ISR ([1][1]). With more

OP-030 Restenosis is an important limitation for coronary stenting. The cause of stent restenosis is neointimal hyperplasia developed from smooth muscle and matrix. We aimed to investigate the association between urotensin II (U-II) and restenosis after coronary stenting which causes endothelial

Patients with diabetes mellitus (DM) remain at higher risk for stent restenosis and adverse cardiovascular events, even in the drug-eluting stent era. The polymer free (PF) Amphilimus-eluting stent (AES) has shown promising preliminary results in patients with DM. The aim of this study was to

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEY, WOS: 000329858400280, Turkish Soc Cardiol

Platelets and nitric oxide system play an important role in coronary disease. Platelet and eNOS polymorphism could be asociated with stent restenosis and coronary events. We included 92 patients (pts) with previous PCI referred to cath lab. We consider cases pts with confirmed angiographic

Presence of stent fracture (SF) after sirolimus-eluting stent (SES) implantation has reported to be associated with an increased risk of adverse events and those are previously reported. But little is known about the outcomes after re-intervention for SES restenosis lesion with SF. From April 2007

In the multicenter randomized STent REStenosis Study (STRESS), stent (S) implantation has shown to reduce restenosis (RES) by 26% compared with PTCA. To determine the impact of Svs PTCA in reducing RES in various vessel locations, we analyzed the data from STRESS in LAD and non-LAD vessels. LAD PTCA N = 98 LAD S N = 96 Non-LAD PTCA N = 104 Non-LAD S N = 109 Final % stenosis 34 ± 15 17 ± 11 † 35 ± 14 20 ± 12 † Acute gain (mm) 1.14 ± 0.47 1.62 ± 0.43 † 1.32 ± 0.49 1.81 ± 0.47 † Late Loss (mm) 0.52 ± 0.55 0.78 ± 0.57 * 0.34 ± 0.57 0.73 ± 0.57 † Net gain (mm) 0.59 ± 0.55 0.88 ± 0.62 * 1.03 ± 0.61 1.06 ± 0.61 RES (g50% stenosIs) 52.6 32.9 * 29.9 29.5 * .p ≤ 0.01 † .p ≤ 0.0001 compared S with PTCA In both LAD and non-LAD vessels, S (compared with PTCA) achieved a greater acute ga in and resulted in a lower final % stenosis. Late loss was also greater in S than PTCA group and similar for LAD and non-LAD vessels. However, in PTCA pts, late loss was much lower in non-LAD vessels (vs LAD). Thus, the overall net gain and RES in non-LAD vessels were similar for S.and PTCA, whereas the net gain was greater after S in LAD vessels and resulted in much lower RES compared with PTCA. Similarly, the difference in eventfree survival (freedom from death, MI, CABG, or repeat PTCA) between S and PTCA was greater in LAD (77% vs 66%, P = 0.06) than non-LAD vessels (78% vs 72%, NS). In Conclusion STRESS substudy analysis indicates 1) S provides uniformly greater improvement of angiographic results in all lesion locations compared with PTCA, 2) much greater anti-restenosis and clinical benefits in S pts within the LAD vessels, and 3) more aggressive post-S dilatation strategies (to further reduce final % stenosis) are recommended for non-LAD vessels to achieve greater differential anti-restenosis benefit for S.

Drug-coated balloons (DCB) rapidly transfer antirestenotic drug along the arterial vessel wall without a metallic implant. DCBs, coated with a mixture of paclitaxel and an excipient (to modulate drug release), may have clinical application in treating coronary in -stent restenosis and in peripheral

Although well established biologic, anatomic, and angiographic predictors of adverse clinical events are known for PTCA, there are a paucity of data after stent (S) implantation. Therefore we compared independent predictors for adverse clinical events (procedural failure, restenosis, and late complications) after S (N = 205) vs PTCA (N = 202) treatment from the randomized multicenter St ent Res tenosis S tudy (STRESS) by performing multivariate logistic analysis. Independent Predictors PTCA (OR, Pvalue) 5tent (OR, Pvalue) Procedure Failure: (final stenosis g 50% andlor death/MI/CABG andlor bailout S) Dissection (362, l 0.005) Final MLD (006, P l 0.005) Angiographic Restenosis: ( ≥ 50% diameter stenosis at follow-up angiogram) Diabetes (2.84, Pl 005) Relerence size (0.31, Pl 0.05) (0.47, P l 0.05) LAD (2.41, P l 005) Final MLD Late Complications: (out-ai-hospital death/ MI/CABG or repeat PTCA, mean follow-up time = 8.8 ± 3.4 months) None Final MLD (0.32, P l 005) Recent( l 6 weeks)M I (2.71, P l 005) In S pts, final minimal lumen diameter (MLD) strongly influenced procedure failure, angiographic restenosis, and late complications. In PTCA pts, postPTCA dissection predicted procedural failure; diabetes, reference size, and LAD predicted restenosis: there were no predictors of late complications. In conclusion The multivariate analysis of STRESS pt outcomes indicates 1) predictors for adverse clinical events were different for Sand PTCA, 2) S neutralized the deleterious impact of biologic and anatomic factors on angiographic restenosis and 3)final MLD after S placement, an operator-controlled variable, strikingly predicted all adverse clinical outcomes. Therefore, meticulous operator attention to optimize final MLD after S placement with appropriate adjunct PTCA may further improve clinical outcomes.

Background: Presence of stent fracture (SF) after sirolimus-eluting stent (SES) implantation has reported to be associated with an increased risk of in-stent restenosis and target lesion revascular...

The 2nd generation DES improved the clinical outcome, however, stent underexpansion and malapposition should be avoided to prevent stent restenosis and subacute stent thrombosis (DES failure). Previous study showed that stent length was strongly associated with DES failure. We investigated 172 de