Percutaneous transluminal coronary angioplasty: state of the art and future directions

Roubin, Gary S.; Gruentzig, Andreas R.

doi:10.1007/bf01884103

Cited by 4 publications

(2 citation statements)

References 49 publications

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“…Arterial lumen loss after injury is determined by arterial remodelling and neointima and/or plaque formation [46]. Arterial remodelling comprises changes in vessel circumference varying from arterial enlargement to shrinkage and is observed during de novo atherosclerosis, after balloon angioplasty, arteriogenesis and also during sustained blood flow changes [47,48].…”

Section: Collagen Synthesis In Cardiovascular Syndromesmentioning

confidence: 99%

Modulation of Collagen Turnover in Cardiovascular Disease

Rodríguez-Feo¹,

Sluijter²,

Kleijn³

et al. 2005

CPD

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Collagen fibers are the most abundant components of the extracellular matrix in arteries and myocardium. Disturbances in the collagen turnover (synthesis and degradation) have been linked to inflammatory diseases including cardiovascular pathological syndromes. In the myocardium, changes in collagen turnover may result in ventricle dilatation and subsequent contractile dysfunction. In arteries, collagen synthesis and degradation are associated with the progression of atherosclerotic disease and intimal hyperplasia following injury. Collagen synthesis is tightly regulated at several levels: synthesis of procollagens, suitable folding of polypeptides, secretion and cross-linking of mature fibers. On the other hand, degradation of newly synthesised procollagen and mature collagen fibers depends on the action of Matrix-Metalloproteinases (MMPs). The major role of collagen turnover in cardiovascular disorders has stimulated the search for pharmacological agents that interfere with collagen turnover at different levels. These drugs can theoretically act through modulation of the synthesis of procollagens or by interference with their post-translational modifications. Another group of pharmacological agents inhibit collagen breakdown (MMP inhibitors). Beneficial effects of compounds that target collagen metabolism have been reported. Unfortunately, many of these compounds also give rise to serious adverse effects due to interference with vital biological processes in which collagen plays an important role. In this paper, we will review cardiovascular diseases in which altered local collagen turnover is a key feature. Subsequently, the effect of compounds that have been developed and tested to modulate collagen synthesis, cross-linking or breakdown will be discussed.

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Section: Collagen Synthesis In Cardiovascular Syndromesmentioning

confidence: 99%

Modulation of Collagen Turnover in Cardiovascular Disease

Rodríguez-Feo¹,

Sluijter²,

Kleijn³

et al. 2005

CPD

View full text Add to dashboard Cite

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“…However, there are other potential indications such as coronary small vessel disease and bifurcation lesions . At the dawn of interventional cardiology, the treatment of coronary artery disease with balloon angioplasty alone was an established treatment option mainly limited by acute vessel closure due to acute recoil, flow‐limiting dissections, and late restenosis . Native vessels treated by stent‐ and polymer‐free DCB keep their vasomotion properties, do not have a risk of ISR and late stent thrombosis, and remain possible targets for coronary artery bypass grafts.…”

Section: Introductionmentioning

confidence: 99%

Drug‐coated balloons for de novo lesions in small coronary arteries: rationale and design of BASKET‐SMALL 2

Gilgen

Farah

Scheller

et al. 2018

Clinical Cardiology

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The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug‐eluting stents (DES) have limited efficacy due to increased rates of instent‐restenosis, mainly caused by late lumen loss. Drug‐coated balloons (DCB) are a promising technique because native vessels remain structurally unchanged. Basel Stent Kosten‐Effektivitäts Trial: Drug‐Coated Balloons vs. Drug‐Eluting Stents in Small Vessel Interventions (BASKET‐SMALL 2) is a multicenter, randomized, controlled, noninferiority trial of DCB vs DES in native SVD for clinical endpoints. Seven hundred fifty‐eight patients with de novo lesions in vessels <3 mm in diameter and an indication for percutaneous coronary intervention such as stable angina pectoris, silent ischemia, or acute coronary syndromes are randomized 1:1 to angioplasty with DCB vs implantation of a DES after successful initial balloon angioplasty. The primary endpoint is the combination of cardiac death, nonfatal myocardial infarction, and target‐vessel revascularization up to 1 year. Secondary endpoints include stent thrombosis, Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding, and long‐term outcome up to 3 years. Based on clinical endpoints after 1 year, we plan to assess the noninferiority of DCB compared to DES in patients undergoing primary percutaneous coronary intervention for SVD. Results will be available in the second half of 2018. This study will compare DCB and DES regarding long‐term safety and efficacy for the treatment of SVD in a large all‐comer population.

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Repeat coronary angioplasty: Correlates of a second restenosis

Black

Anderson

Roubin

et al. 1988

Journal of the American College of Cardiology

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To identify the correlates of a second restenosis after repeat percutaneous coronary angioplasty, the records of 384 patients with single vessel disease who underwent repeat angioplasty for restenosis complicating a first elective angioplasty were examined. A second restenosis occurred in 47 (31%) of 151 patients having angiographic follow-up. Univariate correlates of a second restenosis were an interval between the first and second angioplasty less than 5 months (41 versus 20% of patients had restenosis, p less than 0.01), male gender (35 versus 12%, p less than 0.05), lesions length greater than or equal to 15 mm before the second angioplasty (62 versus 28%, p less than 0.05), diameter stenosis greater than 90% before the second angioplasty (67 versus 29%, p less than 0.05), final gradient greater than 20 mm Hg after the second angioplasty (52 versus 28%, p less than 0.05) and an additional site requiring dilation at the time of the second angioplasty (50 versus 29%, p = 0.10). Multivariate predictors of a second restenosis were an interval of less than 5 months between the first and the second angioplasty (p = 0.001), male gender (p = 0.001), lesion length greater than or equal to 15 mm before the second angioplasty (p = 0.001) and the need to have an additional site dilated at the time of the second angioplasty (p = 0.002). Patients at increased risk of restenosis after the second angioplasty can be identified and may serve as a useful population for intervention studies.

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Percutaneous transluminal coronary angioplasty: state of the art and future directions

Cited by 4 publications

References 49 publications

Modulation of Collagen Turnover in Cardiovascular Disease

Modulation of Collagen Turnover in Cardiovascular Disease

Drug‐coated balloons for de novo lesions in small coronary arteries: rationale and design of BASKET‐SMALL 2

Repeat coronary angioplasty: Correlates of a second restenosis

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