OBJECTIVES We sought to determine the frequency and timing of complications at our institution when surgery was performed within two months of coronary stent placement. BACKGROUND The optimal delay following coronary stent placement prior to non-cardiac surgery is unknown. METHODS We analyzed the Mayo Clinic Percutaneous Coronary Intervention and Surgical databases between 1990 and 2000 and...

BACKGROUND There is evidence that endothelial coverage of drug-eluting stents might be delayed or absent, a risk factor for late thrombotic events. We studied the effects of different drug-polymer-device iterations on endothelium-dependent coronary vasomotion. Systemic markers of endothelial inflammation were correlated with coronary vasomotor changes. METHODS AND RESULTS Patients with paclit...

BACKGROUND Late results of interventional procedures using coronary stents are largely determined by the rate of restenosis. So far, few data are available addressing the effect of stent design on this crucial variable and on early and late adverse events after stent implantation. METHODS From 1996 through 1998, a total of 965 lesions in 925 patients with coronary artery disease were randomiz...

Over recent decades, the numerous coronary revascularisation procedures performed either by percutaneous coronary intervention (PCI), or coronary bypass surgery has led to an increasing number of patients who are no longer eligible for additional revascularisation procedures. This number of patients is expected to rise even further in view of an increase in life expectancy in patients with coro...

D rug-eluting stents (DES) minimized the occurrence of in-stent restenosis but with a penalty of increased risk of late stent thrombosis. 1 In patients with late stent thrombosis, adverse vessel wall reactions such as uncovered and malap-posed stent struts, coronary aneurysms, and accelerated neo-atherosclerosis 2 have been identified. The stent polymer is suspected to induce an inflammatory re...

BACKGROUND Fractional flow reserve predicts cardiac events after coronary stent implantation. The aim of the present study was to assess the 9-month angiographic in-stent restenosis rate in the setting of optimal stenting and a persisting gradient distal to the stent as assessed by a pressure wire pullback recording in the entire length of the artery. METHODS AND RESULTS In 98 patients with a...

OBJECTIVE It is still controversial whether sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) are equally effective in patients with diabetes. In these patients, multiple individual variables may be responsible for neointimal hyperplasia, thus making difficult the comparison of the two drug-eluting stents (DES). RESEARCH DESIGN AND METHODS We designed a prospective, randomized ...

AIMS To compare coronary stent implantation and bypass surgery for multivessel coronary disease in patients with renal insufficiency. METHODS AND RESULTS In the ARTS trial, 142 moderate renal insufficient patients (Ccr<60 mL/min) with multivessel coronary disease were randomly assigned to stent implantation (n=69) or CABG (n=73). At 5 years, there was no significant difference between the two...

The present study illustrates a possible methodology to investigate drug elution from an expanded coronary stent. Models based on finite element method have been built including the presence of the atherosclerotic plaque, the artery and the coronary stent. These models take into account the mechanical effects of the stent expansion as well as the effect of drug transport from the expanded stent...

BACKGROUND The Orsiro Hybrid sirolimus-eluting stent is a newly developed third-generation drug-eluting stent, featuring a unique dual-polymer mix. An active bioabsorbable polymer delivers the anti-proliferative drug, sirolimus, via controlled release, while a passive biocompatible polymeric coating shields the metallic strut from surrounding tissue, preventing interaction. To date, the Orsiro ...