Symptomatic abnormal vessel wall reaction after implantation of the first generation sirolimus-eluting stent: a case series.

Aims: Expansive vessel wall remodeling has been previously reported after implantation of drug-eluting stents. These abnormal vessel wall reactions (AVWR), though uncommon may be associated with serious clinical events. We report on a series of patients in whom symptoms developed despite patent stents.

Long-term clinical outcome of thin-strut cobalt-chromium stents in the drug-eluting stent era: results of the COBALT (comparison of bare-metal stents in all-comers' lesion treatment) registry.

Background: Despite widespread penetration of drug-eluting stents (DES) in clinical practice, a relevant percentage of patients with coronary artery disease are still treated with bare-metal stents (BMS). Contemporary BMS, however, are less well investigated and comparative data on clinical outcome are lacking.

Methods And Results: This single-center registry aimed to assess characteristics and outcome of patients treated with 2 different new-generation cobalt-chromium BMS, the MULTI-LINK VISION and PRO-Kinetic stents.

Ad-hoc percutaneous coronary intervention and transcatheter aortic valve implantation as a combined transfemoral procedure.

Coronary artery disease has been reported in more than 50% of patients with severe aortic stenosis above the age of 70 years. Combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) is associated with a higher operative risk. Concomitant coronary artery disease also increases the procedural risk of transcatheter aortic valve implantation (TAVI), and hence, a combined strategy for treating both entities needs to be carefully considered.

Determination of haemodynamic significance of intermediate coronary lesions using three-dimensional coronary reconstruction.

Aims: This study evaluates three-dimensional (3-D) reconstruction of the coronary arteries in assessment of angiographically borderline lesions.

Methods And Results: Three-dimensional (3-D) quantitative coronary angiography (QCA) was performed for 41 intermediate coronary stenotic lesions (IL) in 31 patients. Measurements of cross-sectional stenosis (CSS), diameter stenosis (DS) and plaque volume (PV) were correlated with the fractional flow reserve (FFR) values measured with a commercially-available pressure guide-wire.

Plaque characteristics of nonobstructive coronary lesions in diabetic patients: an intravascular ultrasound virtual histology analysis.

Background: Patients with diabetes mellitus are known to be at increased risk for acute cardiovascular events. We used intravascular ultrasound virtual histology (IVUS-VH) to examine whether nonobstructive coronary artery lesions of diabetic patients have distinct plaque composition and morphology compared with nondiabetic patients.

Methods: A total of 41 patients (13 diabetic and 28 nondiabetic) with proximally located angiographically nonobstructive coronary lesions were prospectively enrolled.

Diazepam versus fentanyl for premedication during percutaneous coronary intervention: results from the Myocardial Protection by Fentanyl during Coronary Intervention (PROFIT) Trial.

Background: Sedation is a cornerstone in the premedication for percutaneous coronary intervention (PCI). Benzodiazepines and opioids are frequently used. Previous results suggest that opioids mimic the adaptation to ischemia during repeated balloon inflations and may provide direct myocardial protection in addition to their sedative effect.

Differentiated analysis of an everolimus-eluting stent and a paclitaxel-eluting stent among higher risk subgroups for restenosis: results from the SPIRIT II trial.

Aims: Restenosis is higher among certain subpopulations when subjected to percutaneous coronary interventions even when using drug-eluting stents. The randomised SPIRIT II trial demonstrated the superiority of the XIENCE V Everolimus Eluting Coronary Stent System over the TAXUS Paclitaxel-Eluting Stent System in terms of in-stent late loss at six months among 300 patients treated for de novo native coronary artery lesions.

Methods And Results: In this post-hoc analysis of SPIRIT II we focused on six-month angiographic outcomes of diabetic patients (n=69), left anterior descending arteries (n=149), long lesions >20 mm (n=43), small vessels <3.

Relationship between cardiovascular risk as predicted by established risk scores and coronary artery plaque composition as detected by virtual histology intravascular ultrasound analysis: the PREDICT pilot study.

Aims: Identification of subclinical high-risk plaques is potentially important because they may have greater likelihood for rupture and thrombosis. The aim of this study was to assess the relationship between in vivo coronary artery plaque composition using intravascular ultrasound virtual histology (IVUS-VH) and cardiovascular risk as predicted by clinical risk scores in patients with non-obstructive stable coronary artery disease.

Methods And Results: Forty patients undergoing elective coronary angiography revealing <50% coronary artery stenoses were prospectively included.