Coronary Angioscopic Evaluation for Serial Changes of Luminal Appearance After Pharmacological and Catheter Interventions

Takano, Masamichi; Mizuno, Kyoichi

doi:10.1253/circj.cj-09-0769

Cited by 15 publications

(7 citation statements)

References 77 publications

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“…9 This fact suggests that the bare-metal stent was responsible for the high incidence of W and M, but it was not clarified in the present study as to what factor determined the appearance of W and M.…”

Section: Mechanisms For Formation Of W and Mmentioning

confidence: 59%

Formation of Web- and Membrane-Like Structures on the Edges of Bare-Metal Coronary Stents

Uchida

Matsuyama

et al. 2010

Circ J

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Section: Mechanisms For Formation Of W and Mmentioning

confidence: 59%

Formation of Web- and Membrane-Like Structures on the Edges of Bare-Metal Coronary Stents

Uchida

Matsuyama

et al. 2010

Circ J

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“…Medications such as statins to achieve plaque stabilization are probably useful in the prevention of LST with stents such as the BES and SES that show little plaque-sealing effect. 18,30- 34 NIC was more homogeneous with BES than with SES, and 80% of BES showed homogeneity. In comparisons of the angioscopic findings after PES and SES implantations, PES showed greater NIC heterogeneity than SES.…”

Section: Discussionmentioning

confidence: 86%

Angioscopic Assessment of Arterial Repair Following Biodegradable Polymer-Coated Biolimus A9-Eluting Stent Implantation - Comparison With Durable Polymer-Coated Sirolimus-Eluting Stent -

Awata

Uematsu

Sera

et al. 2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp rug-eluting stents (DES) have drastically reduced in-stent late loss (LL) and target lesion revascularization (TLR) by inhibiting neointimal hyperplasia. 1,2 However, poor reendothelialization, partly due to hypersensitivity reactions to polymer carriers, has gained attention as a cause for late stent thrombosis (LST) with first-generation DES. 3-5With the second-generation DES, various attempts have been made to achieve both inhibitory effects on restenosis and sufficient arterial repair. The TRE-956 stent (Terumo Corporation, Tokyo, Japan) is a second-generation DES that elutes biolimus A9, an analog of sirolimus. Because biolimus A9 is more highly lipophilic than sirolimus, the transport and tissue retention of the drug should be better. 6,7 Biodegradable polymer (polylactic acid) is adopted only to the abluminal stent surface, ensuring that drug is distributed to the target vessel tissue side. Hence, adequate vascular healing as well as strong inhibitory effects on restenosis may be expected with the TRE-956 stent. Using angioscopy, we sought to investigate the intra-stent conditions following biolimus A9-eluting stent (BES) implantation, and to compare the results with the first-generation sirolimus-eluting stents (SES, Cypher, Cordis, Miami Lakes, FL, USA). Methods PatientsThe study subjects consisted of 31 DES implanted in 24 patients (19 men, age range 50-80 years) who suffered from stable angina pectoris. Background: Second-generation drug-eluting stents (DES) are expected to show better arterial repair than older DES. We angioscopically compared the biodegradable polymer-coated biolimus A9-eluting stent (BES) and durable polymer-coated sirolimus-eluting stent (SES) to explore differences in arterial repair.

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“…In the present study, spotty intimal calcification was scattered frequently within the intima of BMS. In-stent vulnerable plaque formed in the extended late phase might be one of the potential causes of VLST after BMS implantation [5]. Based on our current IVUS analysis, we consider that VLST occurs after BMS because of the rupture of a vulnerable plaque developed in BMS several years after implantation.…”

Section: Mechanisms Underlying Vlst After Bms Implantationmentioning

confidence: 95%

“…Delayed reendothelialization [2], incomplete neointimal coverage, late acquired stent malapposition [3], and local hypersensitivity reactions [4] have been suggested to induce VLST after DES implantation. Stent thrombosis of bare-metal stents (BMSs) usually occurs within the first year and rarely in later years because reendothelialization is completed within several months after implantation [5]. However, some cases of VLST after BMS implantation have been reported recently [6,7].…”

Section: Introductionmentioning

confidence: 99%

Calcified plaque rupture and very late stent thrombosis after bare-metal stent implantation

Yumoto

Anzai

Aoki

et al. 2011

Cardiovasc Interv and Ther

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Very late stent thrombosis (>1 year: VLST) is a major concern in the drug-eluting stent (DES) era. VLST occurs not only in patients implanted with DESs but also in those implanted with bare-metal stents (BMSs). We examined intravascular ultrasound (IVUS) findings in patients with VLST after BMS implantation. Five consecutive patients presented with VLST as ST elevation myocardial infarction. VLST occurred at a mean of 9.5 years after BMS implantation. In the IVUS findings, the minimum stent area was 7.8 ± 1.2 mm(2). None of the patients had incomplete stent apposition or stent underexpansion, which was defined as a stent expansion index of <0.8. The mean stent expansion index was 1.01. Calcium deposits in the previous stented segment were observed in 4 patients (80%), and a total of 14 calcium deposits were observed in all patients. The calcification pattern was superficial (78.5%) and spotty (57.1%) within a calcium arc of <90°. The mean calcium arc was 72.5° ± 88.5°. A ruptured plaque with an intraluminal flap was detected in all cases. According to the IVUS findings of ruptured plaque and calcium deposits, VLST after BMS might be caused by a thrombus formation subsequent to a calcified atherosclerotic plaque rupture.

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Coronary Angioscopic Evaluation for Serial Changes of Luminal Appearance After Pharmacological and Catheter Interventions

Cited by 15 publications

References 77 publications

Formation of Web- and Membrane-Like Structures on the Edges of Bare-Metal Coronary Stents

Formation of Web- and Membrane-Like Structures on the Edges of Bare-Metal Coronary Stents

Angioscopic Assessment of Arterial Repair Following Biodegradable Polymer-Coated Biolimus A9-Eluting Stent Implantation - Comparison With Durable Polymer-Coated Sirolimus-Eluting Stent -

Calcified plaque rupture and very late stent thrombosis after bare-metal stent implantation

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