| 21. |
- Sarno, Giovanna, et al.
(författare)
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Morphological and functional evaluation of the bioresorption of the bioresorbable everolimus-eluting vascular scaffold using IVUS, echogenicity and vasomotion testing at two year follow-up : a patient level insight into the ABSORB A clinical trial
- 2012
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Ingår i: The international journal of cardiovascular imaging. - : Springer Science and Business Media LLC. - 1875-8312 .- 1569-5794 .- 1573-0743. ; 28:1, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe vaso-reactivity (by Acetylcholine and Methergine tests) at 2 year follow-up in parallel with the individual changes in the echogenicity characteristics of the polymer struts of the everolimus eluting bioresorbable vascular scaffold (BVS), from post-treatment to 2 year follow-up, in patients enrolled in the ABSORB Cohort A study. Intravascular ultrasound assessment was performed with a phased array catheter (EagleEye, Volcano Corporation, Cordova, CA, USA) with automated pullback at 0.5 mm per second. The % ratio at 6 months and 2 years [(Scaffold Area post PCI- Lumen Area)/Scaffold Area post PCI] was calculated as a measure of scaffold shrinkage. The % change of hyperechogenicity was defined as: ([post-procedural hyperechogenicity] - [2 year follow up hyperechogenicity])/[post-procedural hyperechogenicity]) × 100. The vasomotion test with intracoronary acetylcholine (10(-6) M) or intravenous methergine (0.4 mg) was performed at 2 years. Overall nine patients received all these analyses and were enrolled in the present analysis. A 50-96% reduction in hyperechogenicity was observed between baseline and 2 years, which corresponded to a change in vasoreactivity between 2 and 22%. A vasoconstriction of the scaffolded segment was observed in the 5 patients, who underwent the methergine test, with a mean decrease in lumen diameter after methergine of 9 ± 7% (P = 0.06), while vasodilatation occurred in the 4 patients who underwent the acetylcholine test with a mean increase in lumen diameter after acetylcholine of 8 ± 5% (P = 0.125). Bioresorption of the BVS is accompanied by re-establishment of both endothelial and non-endothelial dependent vasomotion.
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| 22. |
- Shin, Eun-Seok, et al.
(författare)
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Reproducibility of Shin's method for necrotic core and calcium content in atherosclerotic coronary lesions treated with bioresorbable everolimus-eluting vascular scaffolds using volumetric intravascular ultrasound radiofrequency-based analysis
- 2012
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Ingår i: The international journal of cardiovascular imaging. - : Springer Science and Business Media LLC. - 1875-8312 .- 1569-5794 .- 1573-0743. ; 28:1, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- Although Virtual Histology intravascular ultrasound (VH-IVUS) is increasingly used in clinical research, the reproducibility of plaque composition remains unexplored in significant coronary artery and stented lesions. The purpose of this study was to assess the reproducibility of necrotic core and calcium content in atherosclerotic coronary lesions that were treated with a bioresorbable everolimus-eluting vascular scaffold (BVS) using a new measurement method (Shin's method) by VH-IVUS. Eight patients treated with a BVS (Abbott Vascular, Santa Clara, CA, USA) were analyzed with serial VH-IVUS assessments, i.e., pre- and post-stenting, and at 6 months and 2 years follow-up. A total of 32 coronary segments were imaged to evaluate the reproducibility of volumetric VH-IVUS measurements. In Shin's method, contours are drawn around the IVUS catheter (instead of the lumen) and vessel. Overall, in the imaged coronary segment, for necrotic core and dense calcium volumes, the relative intra-observer differences were 0.30 ± 0.22, 0.19 ± 0.16% for observer 1 and 0.45 ± 0.41, 0.36 ± 0.47% for observer 2, respectively. The inter-observer relative differences of necrotic core and dense calcium volumes were 0.51 ± 0.79 and 0.56 ± 1.01%, respectively. The present study demonstrates a good reproducibility for both, intra-observer and inter-observer measurements using Shin's method. This method is suitable for the measurement of necrotic core and dense calcium using VH-IVUS in longitudinal studies, especially studies on bioresorbable scaffolds, because the degradation process will be fully captured independently of the location of the struts and their greyscale appearance.
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| 23. |
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| 24. |
- Siudak, Zbigniew, et al.
(författare)
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Early abciximab use in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention improves long-term outcome. Data from EUROTRANSFER Registry
- 2010
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Ingår i: KARDIOLOGIA POLSKA. - : Polish Cardiac Society / TERMEDIA. - 0022-9032. ; 68:5, s. 539-545
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary percutaneous coronary intervention (PCI) is the preferred method of reperfusion in patients with ST elevation myocardial infarction (STEMI). Abciximab is a well established adjunct to primary PCI. The proper timing of abciximab administration in STEMI patients has been investigated in randomised trials, registries and metanalysis, providing conflicting results. Methods: Consecutive data on STEMI patients, transferred for primary PCI in hospital/ambulance STEMI networks between November 2005 and January 2007, from 15 PCI centres in seven European countries was gathered together for a one-year long-term clinical observation (93% rate of completeness). Results: Data from 1,650 patients was collected in the EUROTRANSFER Registry. Abciximab was administered to 1,086 patients (66%), 727 patients received early (at least 30 minutes prior to first balloon inflation) abciximab (EA), and another 359 patients received late abcixirnab (LA). One year mortality was 5.8% in the EA group vs 10.3% with LA (p = 0.007). Adjustment for propensity score methods for EA administration did not change the results, still providing a favourable outcome for the EA group (p = 0.004). It was also revealed that only a minority of patients (36%) were treated within the 90-minute recommended time window from first medical contact to PCI (and 60% for the 120-min time delay). Conclusions: Patients transferred for primary PCI in STEMI hospital networks showed lower rates of death in long-term one-year clinical follow-up when treatment with abciximab was started early.
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