GW25-e4211 6-Month Follow-Up of a Novel Biodegradable Drug-Eluting Stent Composed of Poly-L-Lactic Acid and Amorphous Calcium Phosphate Nanoparticles in the Porcine Coronary Artery

Using poly-L-lactic acid for implantable biodegradable scaffold has potential biocompatibility issue due to its acidic degradation byproducts. We have previously reported that the addition of amorphous calcium phosphate improved poly-L-lactic acid coating biocompatibility. In the present study, poly-L-lactic acid and poly-L-lactic acid/amorphous calcium phosphate scaffolds were implanted in pig coronary arteries for 28 days. At the follow-up angiographic evaluation, no case of stent thrombosis was observed, and the arteries that were stented with the copolymer scaffold had significantly less inflammation and nuclear factor-κB expression and a greater degree of reendothelialization. The serum levels of vascular endothelial growth factor and nitric oxide, as well the expression of endothelial nitric oxide synthase and platelet-endothelial cell adhesion molecule-1, were also significantly higher. In conclusion, the addition of amorphous calcium phosphate to biodegradable poly-L-lactic acid scaffold minimizes the inflammatory response, promotes the growth of endothelial cells, and accelerates the reendothelialization of the stented coronary arteries.

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STENTYS SELF EXPANDABLE DRUG-ELUTING STENT IN THE TREATMENT OF LEFT MAIN CORONARY ARTERY STENOSIS IN PATIENTS WITH DIABETES: ONE-YEAR FOLLOW-UP OF MULTICENTRE POLISH LM STENTYS DES REGISTRY LM-STENTYS REGISTRY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31736-4 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1195

Author(s):

Wojciech Wanha ◽

Maksymilian Mielczarek ◽

Grzegorz Smolka ◽

Tomasz Roleder ◽

Dariusz Ciecwierz ◽

...

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Coronary Artery Stenosis ◽

Drug Eluting Stent ◽

Left Main ◽

Main Coronary Artery Stenosis ◽

Patients With Diabetes ◽

Drug Eluting ◽

One Year

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Abstract 2524: Long-Term (4 year) Outcome following Drug Eluting Stent Implantation versus Coronary Artery By-pass Surgery in Unprotected Left Main Coronary artery Lesions

Circulation ◽

10.1161/circ.118.suppl_18.s_738-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Alaide Chieffo ◽

Valeria Magni ◽

Francesco Maisano ◽

Alfonso Ielasi ◽

Azeem Latib ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Composite Endpoint ◽

Drug Eluting Stent ◽

Target Vessel Revascularization ◽

Single Center Experience ◽

Cerebrovascular Events ◽

Drug Eluting ◽

One Year

One-year outcome following drug-eluting stent (DES) implantation versus coronary artery by-pass grafting (CABG) in unprotected LMCA lesions have been previously reported from our center. Methods and results Two hundred forty-nine consecutive patients with an unprotected LMCA stenosis electively treated (107 with PCI and DES implantation and 142 with CABG) in our Center, between March 2002 and July 2004, were analysed. Hierarchical study end points were occurrence at 4 years of: death; death and/or myocardial infarction (MI); death, MI and/or stroke; target vessel revascularization (TVR, defined as any revascularization in left coronary system); and major cardiac cerebrovascular events (MACCE). A propensity analysis was performed to adjust for baseline differences between the two cohorts. At 4 year-clinical follow-up, no difference was found between PCI and CABG in the occurrence of death (respectively 12.0% vs. 14.1%; unadjusted odds ratio- OR=0.845; 95% confidence interval-CI=0.365 to 1.890; P=0.80; adjusted OR=0.652; 95% CI=0.254 to 1.620; P=0.42). At adjusted analysis, PCI group showed a trend toward a lower occurrence of the composite endpoint of death and myocardial infarction (13.0% vs. 19.7%; adjusted OR=0.461; 95% CI=0.180 to 1.088; P=0.08). PCI was associated with a lower rate of the composite endpoint of death, MI and/or stroke (respectively 14.0% vs. 22.5%; unadjusted OR=0.519; 95% CI=0.238to 1.071; P=0.07; adjusted OR=0.431; 95% CI=0.175 to 0.971; P=0.04). Indeed, CABG was correlated to lower TVR (8.4% vs. 28% ; unadjusted OR= 5.018; 95% CI= 1.990-23.8; p=0.0001; adjusted OR= 5.928; 95% CI= 1.933 – 38.0; p= 0.0003). No difference was detected in the occurrence of MACCE ( in PCI 36.4% vs. 28.1% in CABG, unadjusted OR=1.409; 95% CI=0.798 to 2.509 P=0.259; adjusted OR=1.438; 95% CI=0.754 to 2.766; P=0.3007). Conclusions At 4 year-clinical follow-up, in this single-center experience, there was still no difference in the occurrence of MACCE between elective PCI with DES implantation and CABG in LMCA lesions. There was an advantage of PCI in the composite endpoint of death, MI and/or stroke, while a benefit in the need for reintervention was still found in CABG. :

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Dynamic kinking of right coronary artery after the button Bentall procedure

BMJ Case Reports ◽

10.1136/bcr-2020-239128 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239128

Author(s):

Tomoki Fukui ◽

Nobuyuki Ogasawara ◽

Shinji Hasegawa

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Multidetector Ct ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Sinus Of Valsalva Aneurysm ◽

Bentall Procedure ◽

Percutaneous Coronary ◽

Drug Eluting

Postoperative coronary artery complications after Bentall procedures are well recognised but are rare and potentially fatal. There have been only five cases documenting percutaneous coronary intervention (PCI) for right coronary artery (RCA) involvements after button Bentall procedures. We describe a case of postoperative silent myocardial ischaemia in a 72-year-old man who underwent the button Bentall procedure for a right sinus of Valsalva aneurysm. On postoperative day 15, an RCA complication was incidentally detected by follow-up multidetector CT. Coronary angiography showed proximal RCA kinking, which was not an anastomosis but a native coronary artery. The patient underwent a successful PCI with drug-eluting stent implantation. We reviewed six cases consisting of this case and five previous cases treated with PCI. These cases enhance the recognition of potential RCA complications after the button Bentall procedure.

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