Objectives: To assess the value of sirolimus-eluting magnesium bioresorbable scaffolds (MgS) in the treatment of patients with in-stent restenosis (ISR). The better option for the treatment of patients with ISR remains unsettled. Bioresorbable vascular scaffolds represent an interesting strategy in this setting to avoid another permanent metal layer. The novel MgS is an attractive option to treat these challenging patients.
Methods: We present the results of the first prospective series of consecutive patients with ISR treated with MgS under optical coherence tomography (OCT) guidance.
Results: A total of 14 patients (15 lesions) were prospectively included. The mean age was 67 ± 9 years and six patients (40%) presented with an acute coronary syndrome. In 10 patients (67%), underlying neoatherosclerosis was disclosed by OCT. An excellent MgS expansion was obtained in all but two patients who showed persistent suboptimal expansion in heavily calcified vessels. Minor residual malapposition ( n = 5) and angiographically silent minor edge dissections ( n = 8) were readily recognized by OCT. After a median clinical follow-up of 30 (range, 20-54) months, no patient required repeated revascularization, suffered a myocardial infarction or device thrombosis.
Conclusions: These preliminary results suggest a potential role for the MgS in selected patients presenting with ISR.
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http://dx.doi.org/10.1097/MCA.0000000000001139 | DOI Listing |
Front Bioeng Biotechnol
December 2024
School of Aeronautic Science and Engineering, Beihang University, Beijing, China.
Introduction: In-stent restenosis remains a significant challenge in coronary artery interventions. This study aims to explore the relationship between exercise intensity and stent design, focusing on the coupled response of the stent structure and hemodynamics at different exercise intensities.
Methods: A coupled balloon-stent-plaque-artery model and a fluid domain model reflecting structural deformation were developed to investigate the interaction between coronary stents and stenotic vessels, as well as their impact on hemodynamics.
Kardiol Pol
January 2024
Cardiology Department, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Rev Cardiovasc Med
December 2024
Department of Cardiology, Bern University Hospital, Inselspital, CH-3010 Bern, Switzerland.
In-stent restenosis (ISR) remains the predominant cause of stent failure and the most common indication for repeat revascularization. Despite technological advances in stent design, ISR continues to pose significant challenges, contributing to increased morbidity and mortality among patients undergoing percutaneous coronary interventions. In the last decade, intravascular imaging has emerged as an important method for identifying the mechanisms behind ISR and guiding its treatment.
View Article and Find Full Text PDFRev Cardiovasc Med
December 2024
Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China.
Background: Despite significant reductions in in-stent restenosis (ISR) incidence with the adoption of drug-eluting stents (DES) over bare metal stents (BMS), ISR remains an unresolved issue in the DES era. The risk factors associated with DES-ISR have not been thoroughly analyzed. This meta-analysis aims to identify the key factors and quantify their impact on DES-ISR.
View Article and Find Full Text PDFJ Biomech
December 2024
PoliTo(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
In-stent restenosis represents a major cause of failure of percutaneous coronary intervention with drug-eluting stent implantation. Computational multiscale models have recently emerged as powerful tools for investigating the mechanobiological mechanisms underlying vascular adaptation processes during in-stent restenosis. However, to date, the interplay between intervention-induced inflammation, drug delivery and drug retention has been under-investigated.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!