Luminal loss and site of restenosis after Palmaz-Schatz coronary stent implantation

Ikari, Yuji; Hara, Kazuhiro; Tamura, Tsutomu; Saeki, Fumihiko; Yamaguchi, Tetsu

doi:10.1016/s0002-9149(99)80041-1

Cited by 62 publications

(23 citation statements)

References 10 publications

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“…[24][25][26] When stent restenosis occurs, the stenotic process usually involves the stent itself or its adjacent margins 27 and neointimal hyperplasia has been indicated as the cause of in-stent restenosis; 28,29 however, the cause of para-stent restenosis is still unknown. Based on the present results, stent implantation might change the segmental movement pattern and an iatrogenic critical movement may develop in the para-stent area resulting in development of a new lesion.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Konta

Bett

2003

Circ J

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espite positive changes in lifestyle and the use of new pharmacological approaches to lowering plasma cholesterol concentrations, the frequency of cardiac death and coronary events continues to be high in Western countries. [1][2][3][4] Many coronary risk factors have been identified, principally through population-based methods, but interestingly, fully half of all patients with coronary disease do not have any of the established coronary risk factors (ie, hypertension, hypercholesterolemia, cigarette smoking, diabetes mellitus, marked obesity, and physical inactivity). 4 Further investigation of the cardiac risk factors has suggested links between various mechanical stresses and the site of lesion predilection and rupture. [5][6][7][8][9] Local stresses may result in the induction of endothelial injury with consequent development of atherosclerosis and tearing soft plaque. [10][11][12] The coronary arteries are tethered to the epicardial surface of the heart and must move with each myocardial contraction. Through repeated observation of the motion of the coronary arteries and the location of plaque formation in diseased vessels, we formed the hypothesis that a critical movement pattern of the coronary arteries may result in localized stress points within the vessel and thus the development of atherosclerosis. 5 The purpose of the present study was to analyze the motion of diseased coronary arteries and examine the correlation between these coronary movement patterns and the sites of identified lesions. MethodsUsing 100 consecutive angiograms performed from August 1999 to September 1999 we retrospectively analyzed the coronary artery movement (CAM) as well as the severity of obstruction. Coronary angiography, which was performed because of suspicion of ischemic heart disease, used standard techniques in multiple projections. The severity of obstruction was calculated by measuring with calipers the diameter of the stenotic area in relation to the adjacent normal artery in the view in which the stenosis was most severe.We classified CAM into 10 patterns (Fig 1): (1) bend = coronary artery flexes into a single large curve; (2) multiple bend = coronary artery flexes into 2 or more curves; (3) compression = segmental length is shortened without vertical deviation of the artery (less than one artery diameter); Patterns of Coronary Artery Movement and the Development of Coronary AtherosclerosisTsuyoshi Konta, MD; John Hugh Nicholas Bett, MB, BS Mechanical stress in coronary arteries has been postulated to cause endothelial injury and atherosclerotic lesions, but the relationship between the pattern of coronary artery movement (CAM) and lesion severity is not known. In the present study CAM was classified into 10 patterns, which were grouped into 3 classes: (1) bend type = coronary artery flexes into a curve; (2) compression type = segmental length is shortened without vertical deviation of the artery; (3) displacement type = location of the coronary artery shifts without change of segmental length or shape. Assessmen...

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Section: Discussionmentioning

confidence: 99%

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Konta

Bett

2003

Circ J

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“…To overcome these shortcomings, flexible second-generation stents were developed and are available in a variety of lengths. The GFX stent is structurally uniform through the entire length without articulation, which theoretically should decrease the potential risk of restenosis caused by stent-to-stent overlap, interstent gaps, and articulation [16]. Recent trials comparing some of the second-generation stents with first-generation devices have shown at least equivalent performance in highly selected patients with relatively simple lesions [17,18], but it is uncertain whether the benefits of stent implantation would also be applicable to longer stenosis.…”

Section: Discussion Single Long-stent Implantation With a Second-genementioning

confidence: 99%

Clinical and angiographic follow-up after single long GFX coronary stent implantation

Nakagawa

Yufu

Nakamori

et al. 2000

Cathet. Cardiovasc. Intervent.

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“…In the present study, the Palmaz-Schatz stent incorporating a spiral bridge was used. It has been shown that when using the PalmazSchatz stent composed of two rigid 7-mm slotted tubes connected by a 1-mm central bridging strut, the largest amount of neointimal formation was located at the articulation site [33] . However, this needs to be investigated further since a recent study found that the largest lumen loss was located in the midportion of the stent regardless of stent type [10] .…”

Section: Clinical and Angiographic Outcome At 6 Monthsmentioning

confidence: 99%

Intravascular ultrasound-guided optimized stent deployment Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

Jaegere

Mudra

Figulla

et al. 1998

European Heart Journal

435

261

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Luminal loss and site of restenosis after Palmaz-Schatz coronary stent implantation

Cited by 62 publications

References 10 publications

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Clinical and angiographic follow-up after single long GFX coronary stent implantation

Intravascular ultrasound-guided optimized stent deployment Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

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