G Dangas

..The incidence of early thrombosis after primary angioplasty and stenting is decreased by abciximab use...

..To report an unusual case of transient contrast encephalopathy arising after carotid artery stenting...

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..Data have correlated this phenomenon with late mortality, and with diffuse atherosclerotic disease. While controversy still exists, the potential for improved mortality after PCI should be fully explored in a systematic way...

..To report the results of carotid artery stenting (CAS) in patients considered to have high-risk anatomical characteristics for carotid endarterectomy...

..22 to 2.60). Thus, regardless of the presence of CKD, baseline characteristics and periprocedural hemodynamic parameters predict CIN, and this complication is associated with worse in-hospital and 1-year outcomes...

..However, this population has high long-term mortality and frequent need for repeat revascularization...

..To evaluate the clinical outcomes of patients undergoing renal artery stenting with intravascular ultrasound (IVUS) guidance and compare measurements between IVUS and angiography...

..Contrast-induced nephropathy (CIN) is a recognized complication after percutaneous interventions (PCI). We sought to determine the impact of gender on incidence and clinical outcome of CIN...

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..Here, we assess whether these initial benefits were maintained at 1 year of follow-up...

..The safety and efficacy of bivalirudin in high-risk patients are unknown...

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..Blood thrombogenicity was reduced with pravastatin in both genders; in addition, thrombin generation was gradually reduced in women to a level similar to that of men by 6 months of follow-up...

..At 30-day follow-up, there were trends toward increased subacute thrombosis with A+C compared with A+T (1.3% vs 0.2%, p = 0.10). These results suggest that A+C may have marginally higher subacute stent thrombosis than A+T...

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..2-4.7, P =.01). CONCLUSION: Repeat stenting for the treatment of focal ISR had a higher postprocedure creatine kinase myocardial band elevation rate and similar long-term clinical results compared with PTCA alone...

..Paradoxically, in this post hoc analysis, the reductions in major bleeding and mortality in ST elevation myocardial infarction afforded by bivalirudin occurred primarily in patients without baseline anemia...

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..Large periprocedural infarctions (signified by new Q waves and CPK-MB >8xULN) are powerful determinants of death, whereas lesser degrees of CPK-MB release and specific device use do not adversely affect survival...

..We report two cases of successful treatment of acute, limb threatening ischemia with intra-arterial Reteplase therapy...

..We evaluated short-term prognosis and resource utilization of consecutive patients treated with percutaneous coronary intervention (PCI) as a function of fluoroscopy time...

..This may explain that the increased clinical restenosis after positive remodeling lesions is treated with non-stent interventions...

..It appears that distal embolic protection may not be necessary during PCI of ISR lesions in degenerated SVGs...

..TIMI 3 flow was achieved in all target vessels after further balloon angioplasty or stenting. The Frontrunner device is a safe and effective tool in the treatment of CTOs from ISR...

..5 vs. 1.5%, p = 0.03). CONCLUSIONS: In this early experience with ACD after PCI, their use was associated with higher vascular complication rates than hemostasis with manual compression...

..In matched lesions, beta and gamma VBT achieved similar reductions in treated segment restenosis and recurrent lesion length compared with placebo...

..03) and a significant residual reference segment stenosis (p = 0.02). CONCLUSIONS: Stent underexpansion and residual reference segment stenosis are associated with stent thrombosis after successful SES implantation...

..Increased periprocedural CK-MB release appears as a trade-off for optimal stent implantation and lower clinical restenosis...

..Vascular brachytherapy with either gamma or beta sources results in significant and similar reductions in restenosis compared with placebo. Similar benefits after VBT prevail in true aorto-ostial lesions...

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..Although most ISAs after SES implantation do not resolve completely, the incidence of restenosis or thrombosis is not affected...

..025). In conclusion, our data show that patients with SVG lesions remain a high-risk subgroup with worse outcomes after percutaneous coronary intervention compared with native vessel disease even in the era of drug-eluting stents...

..A stenting strategy for proximal LAD stenoses appears to attenuate the differences of clinical restenosis noted after non-stent PCI...

..Therefore, the reduction in thrombogenicity was not proportional to the magnitude of LDL-C reduction suggesting that a class or agent specific property is primarily responsible for the pro-fibrinolytic/antithrombotic effects observed...

..001). In the porcine coronary model, site-specific systemic delivery of Rapamycin utilizing PGMC resulted in overexpression of p27 and a significant reduction of neointimal formation within the stented segments...

..03). A gap between SESs was identified in 3 of 11 recurrences versus 1 of 19 nonrecurrent lesions. CONCLUSIONS: Stent underexpansion is a significant cause of failure after SES implantation treatment of ISR...

..In the porcine coronary model, an advanced c-myc-eluting PC stent blocked c-myc expression and significantly inhibited myointimal hyperplasia and allowed complete reendothelialization and healing response...

..Plaque rupture morphology is associated with higher periprocedural CK-MB release and worse 1-year clinical outcome in patients treated with coronary stenting...

..4% to 55.9% for a low and high risk score, respectively). CONCLUSIONS: The risk of CIN after PCI can be simply assessed using readily available information. This risk score can be used for both clinical and investigational purposes...

..We assessed the outcomes in diabetic patients undergoing percutaneous coronary intervention (PCI) using sirolimus-eluting stents (SES) as a function of treatment with glycoprotein (GP) IIb/IIIa inhibitors...

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..This case report describes in-stent restenosis due to stent underexpansion after kissing stents using sirolimus-eluting stents...

..We sought to compare the efficacy of tirofiban and abciximab on platelet inhibition as well as their effects of platelet inhibition on C-reactive protein levels during percutaneous coronary intervention (PCI)...

..High levels of procedural anticoagulation with heparin were found to increase hemorrhagic complications without improving clinical or angiographic outcomes...

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..Newer pharmacologic agents and drug-eluting stents may address both of these issues...

..We sought to evaluate and validate the ability of the angiographic myocardial blush grade to risk stratify patients after successful angioplasty in acute myocardial infarction (AMI)...

..Ensuring adequate stent dimensions and wall contact can contribute to successful outcomes in patients receiving SES...

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..The intravascular ultrasound (IVUS) findings during repeat intervention for drug-eluting stent (DES) restenosis have not been well described...

..Pilot trials suggest that the thrombin-specific anticoagulant bivalirudin may improve clinical outcomes in ACS...

..02) but similar target vessel revascularization (35.1% vs 29.8%, p = 0.4) at follow-up...

..To gain insight into the outcome of women after new-device angioplasty, we reviewed the early and late clinical outcome of 7,372 patients undergoing new-device angioplasty between 1991 and 1996 at the Washington Hospital Center...

..Plaque rupture itself does not lead to symptoms. The association of plaque rupture with a smaller lumen area and/or thrombus formation causes lumen compromise and leads to symptoms...

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..Therefore, there does not appear to be any "downside" to aggressive stent implantation strategies in small vessels. In contrast, IVUS allows maximization of final lumen dimensions to minimize clinical restenosis...

..This study found that the new Angio-Seal STS Platform device can secure hemostasis after PCI in a safe and effective manner similar to the old device. The new platform is easier for the operator and for the patients...

..7) were similar. Negative remodeling is frequently observed in lesions with intermediate stenosis. This suggests that negative remodeling occurs early in lesion formation...

..Minimally invasive coronary artery bypass (MIDCAB) is a new surgical technique by which the left internal mammary artery is anastomosed under direct visualization to the left anterior descending artery without cardiopulmonary bypass...

..To study the impact of detection of viability of myocardium in asymptomatic patients early (3-10 days) after Q-wave myocardial infarction on segmental recovery of left ventricular function after elective revascularization...

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..01) than patients with no predictors. In conclusion, VH-IVUS analysis showed that the percentage of NC and its ratio to DC in diseased coronary segments are positively associated with a high-risk ACS presentation...

..79). CONCLUSIONS: In the setting of Dx angiography, the risk of access-site-related complications was similar for ACD compared with mechanical compression. In the setting of PCI, the rate of complications appeared higher with VasoSeal...

..e., drug-eluting stents) are available. Shorter time from brachytherapy to radiation failure and late thrombosis after brachytherapy were independent predictors of adverse events...

..In conclusion, in this observational, nonrandomized study, pretreatment with the AngioSculpt balloon enhanced stent expansion and minimized the difference between predicted and achieved stent dimensions...

..Lesion length remains a powerful predictor of recurrent ISR and clinical events after treatment of ISR even with gamma-RT...

..Notably, the need for bypass graft surgery due to restenosis is reduced after TAXUS stent implantation in LAD lesions...

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..DM remains a powerful predictor of TLR and major adverse cardiac events even after treatment of ISR with gamma-RT...

..These differences are independent of stent manufacturer, length, diameter, and deployment pressure...

..Whether correcting the hematocrit prepercutaneous coronary intervention might decrease the rates of contrast-induced nephropathy should be addressed in a prospectively designed trial...

..Compelling data on the central role of platelets in arterial thrombosis have made apparent the need for more potent antiplatelet agents for the treatment of patients undergoing PCI...

..Moreover, they correlated with persistent troponin-I elevation at follow-up, and with late myocardial infarction...

..Neointimal hyperplasia after PTCA is an important component of restenosis...

..There was 1 in-stent and 1 in-segment (proximal edge) restenosis in the metallic stent group. There was no stent thrombosis or aneurysm formation at follow-up in either group...

..A less aggressive stent implantation strategy in SVGs than in native coronary lesions appears prudent...

..Treatment with either repeated DES implantation or balloon angioplasty for DES-ISR was safe and associated with low overall rates of target-lesion revascularization and major adverse cardiac events at 1 year...

..Therefore, clopidogrel plus aspirin should replace ticlopidine plus aspirin as the standard antiplatelet regimen after stent deployment...

..By multivariate analysis, use of GP IIb/IIIa inhibitors during stenting with the TAXUS stent was an independent predictor of CK-MB increases >3 times the normal level. Further studies are warranted...

..0001), and CRF (OR = 1.74; P = 0.003) were independent correlates of increased late mortality. Therefore, PCI in patients with impaired renal function, whether on dialysis or not, is associated with poor in-hospital and 1-year survival...

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..Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach...