These data suggest that, whenever possible, non-cardiac surgery should be delayed six weeks after stent placement, by which time stents are generally endothelialized, and a course of antiplatelet therapy to prevent stent thrombosis has been completed.

Background-Previous studies have demonstrated that experimental hypercholesterolemia leads to neovascularization in the coronary artery vasa vasorum (VV). Recent evidence suggests that HMG-CoA reductase inhibitors (statins) have beneficial effects independent of lipid lowering. We aimed to determine the effect of simvastatin on coronary VV neovascularization, in the absence of cholesterol lowering. Methods and Results-Pigs were randomized to 3 groups fed a normal (N), high cholesterol (HC), or HCϩsimvastatin (HCϩS) diet for 12 weeks. The proximal left anterior descending artery was isolated, scanned with micro-CT, and reconstructed. Quantification of the VV density in serial cross-sections along the vessel was then performed. LDL cholesterol was similarly increased in HC and HCϩS compared with N. There was an increase in both VV density (4.

Abstract-Recent evidence suggests that some benefit from the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors may occur independent of lipid lowering. We aimed to determine the effect of simvastatin on coronary endothelial function, endothelial NO synthase (eNOS) expression, and oxidative stress in experimental hypercholesterolemia (HC) in the absence of cholesterol lowering. Pigs were randomized to 3 experimental groups: normal diet (N group), high cholesterol diet (HC group), and HC diet with simvastatin (HCϩS group) for 12 weeks. Low density lipoprotein cholesterol was similarly increased in the HC and HCϩS groups compared with the N group. In vitro analysis of coronary large-and small-vessel endothelium-dependent vasorelaxation was performed.

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Background-Experimental hypercholesterolemia (HC) impairs intramyocardial microvascular function. However, whether this is associated with alterations in microvascular architecture remained unknown. Using a novel 3D micro-CT scanner, we tested the hypothesis that HC is associated with an alteration in the microvascular architecture. Methods and Results-Pigs were euthanized after 12 weeks of either normal (nϭ6) or 2% HC (nϭ6) diet. The hearts were excised and the coronary arteries injected with a radiopaque contrast material. Myocardial samples were scanned with micro-CT, and 3D images were reconstructed with 21-m cubic voxels. The myocardium was tomographically subdivided into subepicardium and subendocardium, and microvessels (Ͻ500 m in diameter) were counted in situ within each region.In the subendocardium of HC pigs, the intramyocardial density of microvessels was significantly higher than in normal animals (1221.4Ϯ199.7 versus 758.3Ϯ90.8 vessels/cm

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The in-hospital and long-term clinical outcomes in patients undergoing a coronary intervention are equivalent when comparing stenting without balloon predilation with balloon angioplasty followed by stenting. Direct stenting is associated with decreased utilization of contrast agent and equipment and shorter procedure times. A randomized study should be performed to better determine the impact of this technique on short- and long-term procedural outcomes.