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graft restenosis

Cécilia Delattre, Diego Velazquez, Caroline Roques, Graciela Pavon-Djavid, Véronique Ollivier, Anna Lokajczyk, Thierry Avramoglou, Virginie Gueguen, Liliane Louedec, Giuseppina Caligiuri, Martine Jandrot-Perrus, Catherine Boisson-Vidal, Didier Letourneur, Anne Meddahi-Pelle
Introduction: The major complications of stent implantation are restenosis and late stent thrombosis. PBMA polymers are used for stent coating because of their mechanical properties. We previously synthesized and characterized Dextrangraft-polybutylmethacrylate copolymer (Dex-PBMA) as a potential stent coating. In this study, we evaluated the haemocompatibility and biocompatibility properties of Dex-PBMA in vitro and in vivo . Methods: Here, we investigated: (1) the effectiveness of polymer coating under physiological conditions and its ability to release Tacrolimus®, (2) the capacity of Dex-PBMA to inhibit Staphylococcus aureus adhesion, (3) the thrombin generation and the human platelet adhesion in static and dynamic conditions, (4) the biocompatibility properties in vitro on human endothelial colony forming cells ( ECFC) and on mesenchymal stem cells (MSC) and in vivo in rat models, and (5) we implanted Dex-PBMA and Dex-PBMATAC coated stents in neointimal hyperplasia restenosis rabbit model...
2019: BioImpacts: BI
Allison B Hall, Emmanouil S Brilakis
Saphenous vein graft (SVG) percutaneous coronary intervention carries high rates of acute (no reflow and periprocedural myocardial infarction) and long-term (restenosis and re-occlusion) complications. Long-term follow-up from the two largest trials of drug-eluting vs. bare metal stents in SVG lesions (The Drug-Eluting Stents vs. Bare Metal Stents In Saphenous Vein graft Angioplasty and Is Drug-Eluting-Stenting Associated with Improved Results in Coronary Artery Bypass Grafts? Trial) definitely show no difference between the two stent types, suggesting that bare metal stents should be preferred given lower cost...
February 15, 2019: Catheterization and Cardiovascular Interventions
Byeoung-Hoon Chung, Seon-Hee Heo, Yang-Jin Park, Young-Wook Kim, Shin-Young Woo, Dong-Ik Kim
BACKGROUND: Primary closure (PC) and patch angioplasty (PA) during carotid endarterectomy (CEA) have been disputed in many studies. Some studies announced that PC is associated with a higher restenosis rate. The aim of this study was to evaluate the outcomes of PC and PA using propensity score matching (PSM). METHODS: Between November 1994 and October 2016, 1044 patients underwent primary CEA procedures at our institution and were retrospectively analyzed. The study endpoints included rates of ipsilateral stroke, any clinical stroke, cranial nerve palsy, hematoma, bleeding warranting repeat surgery within 30 postoperative days...
February 11, 2019: Annals of Vascular Surgery
Florah Tshepo Moshapa, Kirsten Riches-Suman, Timothy Martin Palmer
Type 2 diabetes mellitus (T2DM) is increasing worldwide, and it is associated with increased risk of coronary artery disease (CAD). For T2DM patients, the main surgical intervention for CAD is autologous saphenous vein grafting. However, T2DM patients have increased risk of saphenous vein graft failure (SVGF). While the mechanisms underlying increased risk of vascular disease in T2DM are not fully understood, hyperglycaemia, insulin resistance, and hyperinsulinaemia have been shown to contribute to microvascular damage, whereas clinical trials have reported limited effects of intensive glycaemic control in the management of macrovascular complications...
2019: Cardiology Research and Practice
Hongzhou Duan, Dapeng Mo, Yang Zhang, Jiayong Zhang, Liang Li
OBJECTIVESymptomatic steno-occlusion of the proximal vertebral artery (VA) or subclavian artery (ScA) heralds a poor prognosis and high risk of stroke recurrence despite medical therapy, including antiplatelet or anticoagulant drugs. In some cases, the V2 segment of the cervical VA is patent and perfused via collateral vessels. The authors describe 7 patients who were successfully treated by external carotid artery (ECA)-saphenous vein (SV)-VA bypass.METHODSSeven cases involving symptomatic patients were retrospectively studied: 3 cases of V1 segment occlusion, 2 cases of severe in-stent restenosis in the V1 segment, and 2 cases of occlusion of the proximal ScA...
February 1, 2019: Neurosurgical Focus
Miguel Bravo, Gianluca Torregrossa, Donna Mancini, John Puskas
A 60 year old female developed Cardiac Allograft Vasculopathy (CAV) 9 years after heart transplantation and treated with drug-eluting stent (DES) in the LAD. Recurrence of in stent restenosis (ISR) was treated with another DES. Recurrent IRS was again observed and Robotic Mid-CABG surgery was successfully performed. Mid-CABG is a plausible alternative in patients with CAV and offer the excellent result of LITA to LAD graft despite a sternotomy-spare approach. This is the first case report of the adoption of this technique in a redo heart transplant patient, opening the scenario for a new tool in the treatment of CAV...
January 30, 2019: Annals of Thoracic Surgery
Kenji Kawai, Hirokuni Akahori, Takahiro Imanaka, Kojiro Miki, Nagataka Yoshihara, Koji Yanaka, Tohru Masuyama, Masaharu Ishihara
In-stent restenosis (ISR) remains a tough problem after percutaneous coronary intervention (PCI) despite advances in technology of drug-eluting stents (DES). A 63-year-old man undergoing hemodialysis was diagnosed with non-ST elevation acute coronary syndrome (NSTE-ACS). An emergency coronary angiography (CAG) revealed severe stenosis in the middle left circumflex artery (LCx). After pre-dilatation with non-compliant balloon, primary PCI was successfully performed with DES implantation. Four months after, CAG was performed again and verified ISR of LCx under diagnosis of recurrent NSTE-ACS...
January 2019: Journal of Cardiology Cases
Maurizio Domanin, Diego Gallo, Christian Vergara, Pietro Biondetti, Laura V Forzenigo, Umberto Morbiducci
This study explored the potential of hemodynamic disturbances and geometric features to predict long-term carotid restenosis after carotid endarterectomy (CEA). Thirteen CEA for carotid diameter stenosis > 70% were performed with patch graft (PG) angioplasty in nine cases, and primary closure (PC) in four cases. MRI acquisitions within one month after CEA were used for hemodynamic and geometric characterization. Personalized computational hemodynamic simulations quantified the exposure to low and oscillatory wall shear stress (WSS)...
January 18, 2019: Annals of Biomedical Engineering
Rafal Wolny, Gary S Mintz, Mitsuaki Matsumura, Masaru Ishida, Yuqi Fan, Khady N Fall, Manish A Parikh, LeRoy E Rabbani, Ziad A Ali, Dimitri Karmpaliotis, Ajay J Kirtane, Jeffrey W Moses, Akiko Maehara
Outcomes after percutaneous coronary interventions (PCI) in saphenous vein grafts (SVG) are inferior compared with native coronary arteries, but the mechanisms of SVG in-stent restenosis (ISR) have not been well-described. Thus, we aimed to evaluate the patterns of SVG ISR using intravascular ultrasound (IVUS) in 54 SVG ISR lesions. Stent underexpansion was defined as minimum stent area (MSA) <5 mm2 . The time from stent implantation to presentation with ISR (9 BMS, 18 first-generation DES, and 27 second-generation DES) was 3...
April 1, 2019: American Journal of Cardiology
Nandhakumar Vasu, Vijayakumar Subban, S Ajit Mullasari
Percutaneous coronary intervention (PCI) is often denied for individuals with coronary artery disease who are prone to develop contrast-induced acute kidney injury. We report a 73-year-old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with in-stent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guided-PCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the flush medium...
December 2018: Indian Heart Journal
Javairiah Fatima, Vincent P Federico, Salvatore T Scali, Robert J Feezor, Scott A Berceli, Kristina A Giles, Dean J Arnaoutakis, Martin R Back, Gilbert R Upchurch, Thomas S Huber
OBJECTIVE: Patch infection after carotid endarterectomy (CEA) is a rare but devastating complication. A variety of different treatment options are reported; however, there is currently no consensus on how to manage this highly morbid problem. The purpose of this study was to review our experience with management of infectious patch complications after CEA and to highlight utility of femoral vein interposition bypass grafting. METHODS: All CEA patch infection operations at the University of Florida from 2002 to 2017 were reviewed retrospectively...
December 24, 2018: Journal of Vascular Surgery
Tianshu-Chu, Congrong-Gao, Zhiwei-Zhao, Fei-Ling, Ayu-Sun, Yuanbiao-Zheng, Jing-Cao, Jianjun Ge
BACKGROUND: Vein graft restenosis has an adverse impact on bridge vessel circulation and patient prognosis after coronary artery bypass grafting. OBJECTIVES: We used the extravascular supporter α-cyanoacrylate (α-CA), the local application rapamycin/sirolimus (RPM), and a combination of the two (α-CA-RPM) in rat models of autogenous vein graft to stimulate vein graft change. The aim of our study was to observe the effect of α-CA, RPM, and α-CA-RPM on vein hyperplasia...
December 17, 2018: Arquivos Brasileiros de Cardiologia
Sukhdeep Bhogal, Hemang B Panchal, Jayant Bagai, Subhash Banerjee, Emmanouil S Brilakis, Debabrata Mukherjee, Gautam Kumar, Madhan Shanmugasundaram, Timir K Paul
BACKGROUND: Drug eluting stents (DES) are preferred over bare metal stents (BMS) for native coronary artery revascularization unless contraindicated. However, the preferred stent choice for saphenous venous graft (SVG) percutaneous coronary interventions (PCI) is unclear due to conflicting results. METHODS: PubMed, Clinical trials registry and the Cochrane Center Register of Controlled Trials were searched through June 2018. Seven studies (n = 1639) comparing DES versus BMS in SVG-PCI were included...
November 22, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Lingchuang Bai, Jing Zhao, Qian Li, Jintang Guo, Xiangkui Ren, Shihai Xia, Wencheng Zhang, Yakai Feng
Artificial small-caliber vascular grafts are still limited in clinical application because of thrombosis, restenosis, and occlusion. Herein, a small-caliber vascular graft (diameter 2 mm) is fabricated from poly(ε-caprolactone)-b-poly(isobutyl-morpholine-2,5-dione) (PCL-PIBMD) and silk fibroin (SF) by electrospinning technology and then biofunctionalized with low-fouling poly(ethylene glycol) (PEG) and two cell-adhesive peptide sequences (CREDVW and CAGW) with the purpose of enhancing antithrombogenic activity and endothelialization...
November 28, 2018: Macromolecular Bioscience
Meena M Archie, Hugh A Gelabert
BACKGROUND: Subclavian artery aneurysms associated with thoracic outlet syndrome (TOS) have traditionally been managed by open surgical reconstruction. Endovascular subclavian artery reconstruction is novel in the setting of arterial TOS (aTOS). Our objective is to report our results with endovascular subclavian artery reconstruction in aTOS patients over a 10-year period with attention to surgical approach and late results. METHODS: Patients who underwent stent-graft reconstruction of subclavian artery aneurysms associated with aTOS between 2006 and 2016 were identified in a prospective database...
November 23, 2018: Annals of Vascular Surgery
Daniel L Varela, Ehrin J Armstrong
Despite the development of new therapies for the treatment of femoropopliteal disease, nitinol stents remain a mainstay of therapy following balloon angioplasty. Consequently, femoropopliteal in-stent restenosis (FP-ISR) remains an important clinical problem. Interventions used to treat de novo lesions of the femoropopliteal segment have been used to treat ISR lesions, with disappointing outcomes. Early interventions focused on repeat balloon angioplasty, cryoplasty, and various debulking therapies. Recently, treatment has shifted towards the use of stent-grafts, drug-eluting therapies, and combination therapies...
November 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Luciano Barbato, Maria Antonietta Grasso, Salvatore Spagnolo
No abstract text is available yet for this article.
November 15, 2018: European Journal of Cardio-thoracic Surgery
Mathew Wooster, Blake Fernandez, Kelli L Summers, Karl A Illig
BACKGROUND: Subclavian vein stenosis or occlusion at the thoracic outlet is a problem associated with certain anatomic and environmental stresses (venous thoracic outlet syndrome [VTOS]), the presence of central venous catheters, and the high flows associated with arteriovenous (AV) access in the limb. We describe our experience with open and endovascular techniques for restoring patency in highly symptomatic patients. METHODS: A prospectively collected database of patients was queried for patients treated for central venous obstructive disease in the setting of highly symptomatic VTOS and ipsilateral AV access from October 2011 to August 2016...
January 2019: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Kranthi K Kolli, James K Min
Coronary bypass grafting (CABG) is a surgical procedure for anastomosing small grafts to the coronary vessels. The bypass graft bridges the occluded or diseased coronary artery, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscles. Patient-specific (PS) anatomy obtained from coronary computed tomography angiography (CCTA) was used to generate a 3D aorto-coronary model (pre-surgery). Additionally, three more models with idealized grafts (individual and sequential grafts), were created using Boolean operations to represent post-surgery configuration...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Kang Xu, Mohanad Kh Al-Ani, Xin Pan, Qingjia Chi, Nianguo Dong, Xuefeng Qiu
Natural products are used widely for preventing intimal hyperplasia (IH), a common cardiovascular disease. Four different cells initiate and progress IH, namely, vascular smooth muscle, adventitial and endothelial cells, and circulation or bone marrow-derived cells. Vascular smooth muscle cells (VSMCs) play a critical role in initiation and development of intimal thickening and formation of neointimal hyperplasia. In this review, we describe the different originating cells involved in vascular IH and emphasize the effect of different natural products on inhibiting abnormal cellular functions, such as VSMC proliferation and migration...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
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