Clinical and Angiographic Outcomes with Everolimus Eluting Stents for the Treatment of Cardiac Allograft Vasculopathy

Azarbal, Babak; Arbit, Boris; Ramaraj, Radhakrishnan; Kittleson, M.; Young, Amelia; Czer, L.; Rafiei, Behrouz; Currier, Jesse W.; Makkar, Raj; Kobashigawa, Jon A.

doi:10.1111/joic.12071

Cited by 17 publications

(13 citation statements)

References 33 publications

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“…The authors, similarly to our study, analyzed outcomes of PCI with EES in patients with CAV during a longer follow-up of 2.5±1.5 years. Azarbal et al also analyzed clinical and angiographic outcomes of 21 heart transplant recipients who underwent PCI with EES during 12±5 months of followup [19] and observed no deaths during follow-up. The target lesion revascularization rate was 5.9%, again confirming the potentially better outcomes with EES.…”

Section: Discussionmentioning

confidence: 99%

Everolimus-Eluting Second-Generation Stents for Treatment of De Novo Lesions in Patients with Cardiac Allograft Vasculopathy

et al. 2020

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Departmental sources Background: Cardiac allograft vasculopathy is a major cause of cardiac allograft rejection. Percutaneous coronary intervention has become the main form of treatment of significant focal lesions. Despite the significance of the problem, data remain scarce. With a large population of transplant recipients undergoing coronary angiography at our center, we decided to analyze the implications of the use of everolimus-eluting second-generation stents by performing 6-month clinical and angiographic follow-up. Material/Methods: From December 2012 and August 2019, 319 patients after heart transplantation undergoing coronary angiography at our institution were analyzed. Subsequently, 22 patients underwent de novo angioplasty with secondgeneration everolimus-eluting stents. The primary study endpoint was angiographic restenosis as evaluated by quantitative coronary angiography. Secondary outcomes included binary restenosis, target lesion revascularization, and cardiac death during the follow-up period (6 months). Results: Patient comorbidities included hypertension (77.3%), type 2 diabetes mellitus (68.2%), dyslipidemia (68.2%), and obesity (31.8%). Primary success was obtained in all of the treated lesions. The analysis of quantitative coronary angiography after 6-month follow-up revealed low late lumen loss (0.22±0.40). Significant restenosis was observed in 1 of the cases. There were no deaths in the 6-month observation period. Conclusions: In the analyzed population, invasive strategy with second-generation everolimus-eluting stents for de novo lesions in cardiac allograft vasculopathy resulted in a low rate of binary restenosis, low late lumen loss, and no deaths during the 6-month follow-up.

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Section: Discussionmentioning

confidence: 99%

Everolimus-Eluting Second-Generation Stents for Treatment of De Novo Lesions in Patients with Cardiac Allograft Vasculopathy

et al. 2020

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“…PCI in patients with HTx who develop CAV has been associated with greater restenosis rates compared to PCI in patients with native coronary artery disease [4,16]. Use of the fi rst generation drug eluting stents (DES) appears to reduce the incidence of in-stent restenosis in CAV as compared with bare metal stents [17][18][19][20], but they do not appear to improve the clinical end points of death and major adverse cardiac events as stent thrombosis [21,22].…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction, primary percutaneous coronary intervention and stent thrombosis in heart transplanted patient: Potential role of elevated coagulation factor VIII

et al. 2014

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Je prokázáno, že zvýšené koncentrace faktoru VIII představují rizikový faktor vzniku trombózy. V této kasuistice popisujeme případ 51letého pacienta po transplantaci srdce a akutním infarktu myokardu, řešeném implantací stentu, který byl dopraven na oddělení urgentního příjmu se subakutní trombózou stentu. Jako nejpravděpodobnější příčina této trombotické příhody byly uvedeny zvýšené hodnoty faktoru VIII. Článek uvádí i výsledky rešerše příslušné literatury.

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“…Our center's early experience with the use of everolimus-eluting stents in 21 heart transplant patients and 34 CAV lesions was associated with binary restenosis and TLR of 5% and 6%, respectively, at one year, lower rates than previously reported with the use of first-generation DES. [30] Our updated experience of 48 patients and 113 lesions demonstrate 1 and 3-yr in-stent restenosis rates approximating 3% and 10%, respectively [17]. comparable to the use of everolimus-eluting DES in native CAD with 1 and 3-yr target lesion failure rates of 4% and 9% [29].…”

Section: Second-generation Drug-eluting Stentsmentioning

confidence: 99%

Update in the Use of Percutaneous Coronary Intervention for Cardiac Allograft Vasculopathy After Heart Transplantation

Cheng¹,

Kobashigawa²

2019

obm transplant

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Cardiac allograft vasculopathy (CAV) limits long-term survival after heart transplantation. CAV with discrete or tubular lesions can be treated with percutaneous coronary intervention (PCI) with high procedural success. Revascularization with balloon angioplasty, bare-metal stents, and first-generation drug-eluting stents has been associated with high and unacceptable restenosis rates. However, second-generation drug-eluting stents are associated with favorable stent and lesion patency. Stent and lesion patency now closely resemble the expected rates in their use in non-transplant CAD. A PCI strategy with routine follow-up surveillance angiography is associated with favorable survival, and should be considered established therapy especially in patients who are ineligible for retransplantation. Drug-coated balloons may offer an alternative revascularization option and require a shorter duration of dual anti-platelet therapy. Randomized data is needed to determine who to treat, when to treat, and with what to treat CAV after heart transplantation, and the optimal duration of dual anti-platelet therapy.

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Clinical and Angiographic Outcomes with Everolimus Eluting Stents for the Treatment of Cardiac Allograft Vasculopathy

Abstract: Use of an EES is associated with a low incidence of TVR and TLR in patients with TCAD. Further studies are needed to determine whether PCI with EES changes long-term outcomes.

Cited by 17 publications

References 33 publications

Everolimus-Eluting Second-Generation Stents for Treatment of De Novo Lesions in Patients with Cardiac Allograft Vasculopathy

Everolimus-Eluting Second-Generation Stents for Treatment of De Novo Lesions in Patients with Cardiac Allograft Vasculopathy

Acute myocardial infarction, primary percutaneous coronary intervention and stent thrombosis in heart transplanted patient: Potential role of elevated coagulation factor VIII

Update in the Use of Percutaneous Coronary Intervention for Cardiac Allograft Vasculopathy After Heart Transplantation

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