GP IIb/IIIa blockade during peripheral artery interventions.

The activation of the platelet GP IIb/IIIa receptor is the final and common pathway in platelet aggregation. By blocking this receptor, platelet aggregation can be inhibited independently of the stimulus prompted the targeting of this receptor. Several years ago, three drugs have been approved for coronary artery indications.

Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial.

Purpose: To review clinical outcomes of patients with chronic limb ischemia and TASC type C lesions treated with sirolimus-eluting versus bare SMART nitinol self-expanding stents.

Methods: Data were obtained from a randomized, multicenter, double-blinded study conducted in 2 phases. All 93 patients had chronic limb ischemia and superficial femoral artery (SFA) occlusions or stenoses (average lesion length 8.

Multislice computed tomographic angiography versus digital subtraction angiography in the follow-up of nitinol stents in the superficial femoral artery.

Purpose: To compare quantitative and qualitative parameters obtained from digital subtraction angiography (DSA) with multislice computed tomographic angiography (MSCTA) in the follow-up of superficial femoral artery (SFA) stents.

Methods: Thirteen patients who had SMART stents implanted in the SFA were examined systematically with DSA and MSCTA (16-row scanner) at 6 months. Quantitative analysis and morphological assessment were performed on DSA images by an independent core laboratory, while the MSCTA images were analyzed by 2 radiologists in consensus.

Evaluation of various image reconstruction parameters in lower extremity stents using multidetector-row CT angiography: initial findings.

Image quality, visible lumen and patency of lower limb stents was assessed by multidetector-row computed tomography (MDCT) angiography using various reconstruction parameters and the results compared with conventional angiography. Fourteen patients (25 stents) were evaluated. From MDCT datasets, axial and coronal oblique reformations were reconstructed using differing reconstruction parameters (slice thickness, kernel, views).

Peripheral arteries: treatment with antibodies of platelet receptors and reteplase for thrombolysis--APART trial.

Purpose: To prospectively compare the safety and efficacy of combination therapy with the glycoprotein IIb/IIIa antagonist abciximab plus the third-generation thrombolytic agent reteplase versus those of therapy with the standard thrombolytic agent urokinase plus abciximab.

Materials And Methods: The study was approved by the local ethics committee, and patient informed consent was obtained. Patients with peripheral arterial occlusions less than 60 days old (n=120) were enrolled in the study: 50 patients (32 men, 18 women; mean age, 67 years; range, 23-88 years) received reteplase plus abciximab and 70 patients (36 men, 34 women; mean age, 68 years; range, 28-88 years) received urokinase plus abciximab.

Early effects of rhenium-188 treatment on proliferation, migration, and matrix synthesis of cultured human aortic smooth muscle cells.

Background And Purpose: Due to its properties rhenium-188 (188Re) seems to be a promising radionuclide for stent coating to reduce restenosis following percutaneous transluminal angioplasty (PTA). In order to characterize the early effects of local 188Re treatment, human aortic smooth muscle cells (HaSMCs) were incubated with different doses of 188Re.

Material And Methods: 2 days after plating, HaSMCs were treated for a period of 5 days with 188Re.

Superficial femoral artery: current treatment options.

Treatment of the superficial femoral artery (SFA) has been among the least effective of all endovascular procedures in terms of long-term patency. The relatively small vessel lumen, in conjunction with a high plaque burden, slow flow, and a high frequency of primary occlusions, contributes to a considerable rate of acute technical failures. Because of these technical limitations a much effort has been made during the past years.

Prevention of carotid artery restenosis after sirolimus-coated stent implantation in pigs.

Background And Purpose: To test the feasibility of self-expanding drug-coated nitinol stents for prevention of restenosis in an animal model. Stent implantation in the carotid artery (CA) has been shown to be feasible for treatment of CA stenosis. Even though the restenosis rate in CA is reported to be lower than in the coronary and peripheral arteries, problems may arise with increasing numbers of treated patients and lengthier follow-up.

MRI-compatible incubation chamber for cell culture experiments.

Purpose: To develop an incubation chamber that is compatible with MRI, while avoiding sources of error due to the experimental setup.

Materials And Methods: Two identical and gas-tight chambers were constructed of Plexiglas. The temperature and the CO(2) concentration were adjustable.

Technical report and preliminary clinical data of a novel catheter for luminal re-entry after subintimal dissection.

Rationale And Objectives: The objective of this study was to evaluate the safety and the effectiveness of the Outback catheter for intraluminal re-entry after subintimal dissection in the crossing of chronic arterial occlusions.

Methods: This study was a proof-of-concept feasibility. Ten patients with totally occluded arteries in the iliac artery to the distal femoral artery (mean occlusion length, 13.

Reduced thrombogenicity of nitinol stents--in vitro evaluation of different surface modifications and coatings.

The material and the surface patterns of intravascular stents play a pivotal role in activating platelets and triggering adherence of inflammatory cells that consecutively leads to renarrowing caused by neointimal hyperplasia. To improve these features, besides mechanical and chemical modifications, ways of masking the stent by covering have been developed. In addition, polymer-coated stents are used as vehicle for local drug delivery.

Reduction of intimal hyperplasia with Re-188-labeled stents in a rabbit model at 7 and 26 weeks: an experimental study.

The aim of this study was to analyze the feasibility of (188)Re-labeled stents to reduce neointimal formation in a rabbit atherosclerosis model and to test the long-term effects at 7 and 26 weeks. Fifty-nine male New Zealand White rabbits were fed a 0.5% cholesterol diet for 4 weeks before balloon angioplasty and insertion of Palmaz stents in the infrarenal aorta.

PTFE-covered self-expanding nitinol stents for the treatment of severe iliac and femoral artery stenoses and occlusions: final results from a prospective study.

Purpose: To evaluate the technical performance, safety, and 1-year clinical efficacy of polytetrafluoroethylene (PTFE)-covered nitinol stents in the treatment of atherosclerotic iliac and superficial femoral artery (SFA) disease.

Methods: The multicenter, prospective, nonrandomized COVENT study involved 98 patients (70 men; mean age 64+/-10 years) who received PTFE-covered nitinol stents in 107 arteries (60 iliac and 47 SFAs) after predilation. The average lesion length was 50 mm in the SFA and 45 mm in the iliac arteries.

Sirolimus-eluting versus bare nitinol stent for obstructive superficial femoral artery disease: the SIROCCO II trial.

Purpose: To investigate further the safety and efficacy of the sirolimus-eluting S. M.A.

Evaluation of magnetic navigation in an in vitro model of uterine artery embolization.

Purpose: To compare steering of a novel magnetic guide wire with a standard 0.014-inch guide wire within a vascular phantom.

Materials And Methods: The magnetic guiding system (MGS) was composed of two permanent magnets on each long side of the fluoroscopy table generating a 0.

The effects of paclitaxel on the three phases of restenosis: smooth muscle cell proliferation, migration, and matrix formation: an in vitro study.

Purpose: We sought to evaluate the growth-modulating potential of paclitaxel on cultured human arterial smooth muscle cells depending on the administered dose.

Material And Methods: For all experiments human arterial smooth muscle cells (SMCs) were used. SMCs were either cultured for 5 days or for 20 days with paclitaxel (doses: 10(-7) M, 10(-8) M, 10(-9) M).

Radiopacity of current endovascular stents: evaluation in a multiple reader phantom study.

Purpose: To evaluate the radiopacity of endovascular stents based on the fluoroscopy mode in a phantom of the human pelvis.

Materials And Methods: The following stents were included in this study: Medtronic AVE Bridge, Medtronic AVE Bridge X, Cordis Covered Nitinol (Covent), Guidant Dynalink, Luminexx, Guidant Megalink, Memotherm Flexx, Palmaz Medium, Palmaz-Schatz Long-Medium, Palmaz Corinthian PQ394Q and PQ294Q, SelfX, SMART without markers, SMART with radiopaque markers, Easy Wallstent. To evaluate radiopacity, images of the stents placed in four different positions (lumbosacral junction left and right, iliosacral joint left and right) of a pelvic phantom were taken at the following modes: spotfilm, continuous fluoroscopy, 15 pulses per second, 7.

Determinants of stent expansion in curved stenotic lesions: an in vitro experimental study.

Purpose: This study compared the expansion parameters of four different new-generation balloon-expandable stents in a curved stenotic phantom model.

Materials And Methods: Five stents for each length and type, each with a 3.5-mm diameter (AVE, 12 mm and 18 mm; Penta, 13 mm and 18 mm; BX-Sonic, 13 mm and 18 mm; and Jostent Flex Master, 12 mm and 16 mm), were implanted in curved silicon models 3.

Clinical evaluation of a computer simulated prediction model of contrast enhancement of the liver in spiral CT.

Objective: A software program was developed simulating a compartmental model of blood circulation based on differential equations. The aim of this study was to compare software-simulated levels of hepatic enhancement with the true values in patients and to test how many patients reach the simulated hepatic enhancement level.

Methods: As software program the CT application software carebolus 2 (Siemens, Forchheim, Germany) was used.

Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month results.

Background: Stent implantation for obstructive femoropopliteal artery disease has been associated with poor long-term outcomes. This study evaluated the effectiveness of shape memory alloy recoverable technology (SMART) nitinol self-expanding stents coated with a polymer impregnated with sirolimus (rapamycin) versus uncoated SMART Stents in superficial femoral artery obstructions.

Methods And Results: Thirty-six patients were recruited for this double-blind, randomized, prospective trial.

Frequent embolization in peripheral angioplasty: detection with an embolism protection device (AngioGuard) and electron microscopy.

Purpose: To evaluate the deliverability and protection capabilities of an embolism protection filter in angioplasty of peripheral arteries.

Methods: The Angioguard emboli capture guidewire system was applied in 11 patients with femoropopliteal lesions (6 stenoses, 3 occlusions, 2 controls). Data on lesion crossing, flow deceleration and macroembolization were recorded.

Impact of glafenine hydrochloride on human endothelial cells and human vascular smooth muscle cells: a substance reducing proliferation, migration and extracellular matrix synthesis.

The aim of this study was to examine the effects of glafenine hydrochloride (a nonsteroidal anti-inflammatory drug) on proliferation, clonogenic activity, cell-cycle, migration, and the extracellular matrix protein tenascin of human aortic smooth muscle cells (haSMCs) and human endothelial cells (ECs) in vitro.HaSMCs and ECs were seeded in tissue culture flasks. The cells were treated for 4 days with glafenine hydrochloride (10 microM, 50 microM, 100 microM).

MR imaging-guided adrenal biopsy using an open low-field-strength scanner and MR fluoroscopy.

Objective: The aim of our study was to test the feasibility and specific properties of MR imaging-guided adrenal biopsy using an open 0.2-T scanner and MR fluoroscopic fast imaging with steady-state free precession sequences.

Conclusion: MR imaging-guided biopsy of the adrenal gland is feasible and safe.

All-trans and 9-cis retinoid acids inhibit proliferation, migration, and synthesis of extracellular matrix of human vascular smooth muscle cells by inducing differentiation in vitro.

The aim of this study was to evaluate the effects of 9-cis retinoid acid (9-cis RA) and all-trans RA (ATRA) on proliferation, migratory ability, synthesis of extracellular matrix, intracellular signal transduction, and differentiation of human aortic smooth muscle cells (haSMCs) in vitro. Changes of cell proliferation following incubation with RAs in different doses (10-6 M, 10-7 M, and 10-8 M) were determined directly by proliferation kinetics and indirectly by bromodeoxyuridine enzyme-linked immuno sorbant assays and colony-formation assays. The migratory ability of haSMCs was examined with the help of migration assays.