Drug eluting stent ppt

See how Resolute Onyx DES is different Still, there were concerns that drug-eluting stents were associated with a rare but serious complication called in-stent thrombosis. No other stent combines a unique metallic spring tip with an innovative dual-pattern strut design that advances deliverability in highly complex anatomy for outstanding clinical outcomes. Dake, M. For the heart to be able to function properly, it also needs a constant supply of Current & Future Stent Design for Drug-eluting Stent-Focused on the Updated Resolute Program - Seung‐Woon Rha, MD, PhD, FACC, FAHA, FESC, FSCAI, FAPSIC Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea Stent Underexpansion in a Patient Presenting With Late Stent Thrombosis of a Drug-Eluting Stent Placed in the LAD. Safety The Medical Services Advisory Committee (MSAC) report on Drug Eluting Stents (November, 2004)1 found that based on current evidence, drug eluting stents are as safe as bare metal stents for the treatment of de novo atherosclerotic lesions of the coronary Additionally, while drug-eluting stents may be more effective in reducing re-stenosis and the subsequent need for re-intervention, safety concerns (i. Loading Unsubscribe from medicaldump? Cancel Unsubscribe. PowerPoint Presentation on Treatment of Drug-Eluting Stent Restenosis with the Same versus Different Drug Eluting Stent or PowerPoint Presentation on crt, interventional cardiology, IM Drug Eluting Stents and Multivessel Disease PCI Drug-eluting stents are placed in a fashion similar to other stents; however, their use markedly reduces the rate of renarrowing. 0 x 18 mm) n=5, SYNERGY Stent System (4. 02, pp. The blood carries oxygen and nutrients that your body needs to work correctly.


The presented case illustrates a successful endovascular approach in a patient with new onset of claudication intermittent after 50m walking distance and angiographic evidence of an occluded drug-eluting stent in the superficial femoral artery. A stent is a foreign object in the body, and the body responds to the stent’s presence in a variety of ways. Drug-eluting stents, however, require longer treatment with blood thinners to prevent the stents from closing because of blood clotting. DIFFERENT CORONARY STENT DESIGN DR AWADHESH KUMAR SHARMA DEPARTMENT OF CARDIOLOGY PGIMER & DR RML HOSPITAL,NEW DELHI 2. Discover the benefits and risks of each treatment. This is where a blood clot forms in a stent one or more years Coronary arterial healing occurs after the placement of a drug-eluting stent, but complete healing of the vessel takes time. The paclitaxel drug-eluting balloon (DEB) is an interesting emerging device to optimise the clinical outcomes in these specific lesions. Listing a study does not mean it has been evaluated by the U. Chicago(Vascular(Specialists(Park(Ridge,(IL Introduction.


The rate-controlling system ensures drug retention during stent deployment and modulates drug-elution kinetics. Drug-Eluting Balloon: Drug-Eluting Balloon B. Drug-eluting stent, -limus drugs, biodegradable polymers, bioresorbable stent, stent thrombosis, double antiplatelet therapy) Disclosure JTH is in receipt of an unrestricted grant from Boston Scientific and has received payments from Medtronic and Boston Scientific for sitting on advisory panels. Learning Objectives. To learn more, contact your Cordis sales rep or fill out the contact form to the right. S. CONCLUSIONS : In the era of drug-eluting stents for diffuse coronary lesions, IVUS-guided percutaneous coronary intervention is superior to angiography-guided percutaneous coronary intervention in reducing the risk of major adverse cardiac events. “Crush The first drug-eluting stent of this group was the Cypher (Cordis Corporation). Consequently, modifications were made to the design, coating, and the choice of drugs, eventually, resulting in (fully) biodegradable drug-eluting stents.


Although the detailed mechanism of Percutaneous treatment of complex coronary lesions, such as small-vessel disease, diabetes and long diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). In this 2-center German trial, 300 patients were randomly allocated to treatment with sirolimus-DES, paclitaxel-DES, or BA. The Resolute Onyx™ stent is manufactured from a composite material of cobalt alloy and Drug-Eluting Stents Current Approach to Review Ashley B. The spacer is made of iopromide , a commonly used contrast agent, which avoids possible artery reactions, as with polymers used to bind the drug to stents. Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents Weiluan Chen , Tom C. akram khan md facc fscai GAITHERSBURG, Md. Comparison of Drug-Eluting Stents Versus Bare-Metal Stents for Treating ST-Segment Elevation Myocardial Infarction Mehdi H. Despite the big benefits of stent-related reductions in restenosis, metal stents had their downside as well. The device is based on the company’s Resolute Integrity device and is delayed healing in the case of drug eluting stents (1).


1 mm Drug Release (%) E-ZES Drug Elution Kinetics 30 20 15 10 5 0 0 0. Almost simultaneously proposed was paclitaxel, which inhibits cell replication and is the drug delivered by the Taxus stents (Boston Scientific). Drug eluting stent technology studies update and overview How far do we still have to go? 7th European Symposium for Vascular Biomaterials Strasbourg 2011 A. Drug-eluting stents for the treatment of coronary artery disease This leaflet is about when drug-eluting stentsshould be used to treat people with coronary artery disease in the NHS in England and Wales. e. 1 Drug-eluting stents are recommended for use in percutaneous coronary intervention for the treatment of coronary artery disease, within their instructions for use Eluting the drug Drug needs to be washed out before endothelium can cover stent Normal endothelium is needed for coagulation hemostasis. DHHS/FDA/CDRH Drug-eluting stent - Cardiology PowerPoint Presentation medicaldump. 51 2 3 5 7 14 28 60 Days 90 180 Zotarolimus E-ZES (ng /mL) Zotarolimus in Arterial Tissue (in Stent) 25 Other 1 or 2 gen DES Zotarolimus-eluting Endeavor Sprint: hydrophilic polymer -based second-generation device with unique drug fast-release profile This advisory addresses the issue of premature discontinuation of antiplatelet drugs in patients with drug-eluting stents, including patients presenting for non-cardiac surgery. 1 mm Introduction.


Background Randomized trials of drug-eluting stents (DES) and drug-coated balloons (DCB) for femoropopliteal interventions reported superior patency rates for both strategies compared to standard balloon angioplasty. Vendors have been working toward reducing strut thickness to help improve overall clinical Drug-eluting stents are placed in a fashion similar to other stents; however, their use markedly reduces the rate of renarrowing. Concern was raised in 2006 regarding the safety of drug-eluting stents due to the risk of blood clots forming on the stent, causing a heart attack. You are about to exit the Abbott family of websites for a 3rd party website. The global peripheral vascular stents market is expected to be driven by increased awareness in low- and middle-income countries, growing investment by manufacturers and governments to cope up with increasing prevalence of peripheral artery disease, and technological advancement in vascular stents such as drug eluting and drug coated stents For multivessel coronary artery disease (CAD), coronary artery bypass grafting (CABG) generally has lower rates of myocardial infarction (MI) and repeat revascularization than percutaneous coronary intervention (PCI), even with drug-eluting stents (DESs); CABG also has shown a trend toward better survival as CAD complexity increases but a higher rate of stroke. Drug eluting stents : clinical trials - Drug eluting stents : clinical trials | PowerPoint PPT presentation | free to view 2018 Drug-eluting Stent Industry Analyzed and Forecast in New Research Report - Analysts forecast the Global Drug-eluting Stent (DES) market to grow at a CAGR of 5. Eluvia Drug-Eluting Stent Product Animation. D. , <10%.


The stent will be left in place to hold the vessel walls open. In this article, the authors provide a critical appraisal of the safety of different drug-eluting stents based on the published clinical data focusing on late and very late stent thrombosis. Drug-eluting stents have a thin surface of medication to reduce the risk of restenosis. 5 of technology appraisal guidance 71 recommend when to use a stent. Dual anti-platelet treatment is recommended for patients receiving coronary stents. J. The paclitaxel drug-eluting balloon (DEB) is an interesting emerging device that optimises clinical outcomes in these specific lesions. Dangas, MD,*† Bimmer E. There are currently several types of drug eluting stent available in Australia.


Sections 1. Approximately 1 year after stent placement, this patient presented with an acute anterior ST-segment elevation myocardial infarction. BACKGROUND The introduction of angioplasty led to the development of a completely new approach to treat CAD. It began with bare-metal stents fabricated from stainless steel and has continued more recently with the advent of drug-eluting stents (DES). Future Advancements The ReZolve™ stent integrates a proprietary drug-eluting polymer and a novel design to create a stent with metal-like performance out of a polymer material. Kok * Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Universiteitsweg 99, 3584 CG Utrecht, The Netherlands Drug-eluting stents reduce the rates of repeat target vessel revascularization or coronary artery bypass grafting surgery. 23-33 Zilver PTX Drug-Eluting Stent Mortality Analysis Gary Ansel, MD, FACC OhioHealth Heart and Vascular Physicians. It is designed with an integrated protection to minimize any kinking. Ellis, Patrick L.


Stent Thrombosis in New-Generation Drug-Eluting Stents in Patients With STEMI Undergoing Primary PCI A Report From SCAAR Giovanna Sarno, MD, PHD,* Bo Lagerqvist, MD, PHD,* Johan Nilsson, MD,y Ole Frobert, MD, PHD,z A new polymer-free drug-eluting stent with nanocarriers eluting sirolimus from stent-plus-balloon compared with bare-metal stent and with biolimus A9 eluting stent in porcine coronary arteries Background: Permanent polymers in first generation drug-eluting stent (DES) have been imputed to be a possible cause of persistent inflammation There is controversy regarding the appropriate duration of dual anti-platelet therapy after coronary stenting. These activities will also address the appropriate use of percutaneous coronary intervention (with DES or bare metal stents) vs bypass surgery in complex patients in need of CAD Treatment Secondary prevention Lifestyle modification Diet, exercise, tobacco cessation Rx underlying risk factors Aspirin and ‘statin’ medications Anti-anginal medications Beta blockers Coronary Bypass Coronary Angioplasty Coronary Angioplasty Coronary Stenting Coronary Stenting Drug Stents Northwestern Memorial Hospital Cardiac F1000Prime Recommended Article: Paclitaxel-eluting balloons, paclitaxel-eluting stents, and balloon angioplasty in patients with restenosis after implantation of a drug-eluting stent (ISAR-DESIRE 3): a randomised, open-label trial. This helps the artery remain smooth and open, ensuring good blood flow and reduces the chances of the artery re-narrowing or restenosis. All over, the drug-eluting stents perform best, but the difference between DES and BMS was less than expected. 79 percent over the period 2013-2018. New generations of drug-eluting stents with novel polymers, antiproliferative drugs, and improved platforms are now approved and available for use. A Brief History of Drug-Eluting Stents This article reviews the evolution of drug-eluting stents (DES), assesses the current market situation and predicts how it might develop in the foreseeable future. JACC. 6 Indeed, cases of late DES The Medtronic Resolute Onyx™ Zotarolimus-Eluting Coronary Stent System (Resolute Onyx™ system) consists of a balloon-expandable, intracoronary, drug-eluting stent (DES) premounted on a Rapid Exchange (RX) or an Over-the-Wire (OTW) stent delivery system.


0 mm diameter by 30 mm long zotarolimus-eluting stent, again with good angiographic result (Figure 1-6A). It explains guidance (advice) from NICE (the National Institute for Health and Clinical Excellence). Accurately assess the risk of bleeding in patients on anticoagulants and antiplatelet agents before endoscopic procedures. 211 - 225, April - June, 2010 utilized. Learn more about the biology and timing of restenosis in the SFA, as well as the stent design, drug-elution profile and clinical outcomes data of the Eluvia Drug-Eluting Stent. In fact, about 1 in 10 patients develops renarrowing in the several years after drug-eluting stent implantation, a rate about half of that seen for stents without medication. Mintz, MD,† Roxana Mehran, MD*† New York, New York The introduction of the drug-eluting stent (DES) proved to be an important step forward in reducing rates of re- Third generation drug eluting stent (DES) with biodegradable polymer in diabetic patients: 5 years follow-up Marcus Wiemer 1*, Sinisa Stoikovic2, Alexander Samol1, Zisis Dimitriadis3, Juan M. PowerPoint Presentation on Treatment of Drug-Eluting Stent Restenosis with the Same versus Different Drug Eluting Stent or PowerPoint Presentation on crt, interventional cardiology, IM Drug Eluting Stents and Multivessel Disease PCI For several years, only two drug-eluting stents, the Cordis CYPHER™ sirolimus-eluting stent and the Boston Scientific TAXUS™ paclitaxel-eluting stent system, were approved by the FDA for sale in the United States (the Cypher stent in April 2003; the Taxus stent was approved a year later in March 2004) as well as the CE mark for sale in Europe. Open ppt.


Hybrid Drug-Eluting Stent Indicated for discrete de novo stenotic lesions and in-stent restenotic lesions Vascular Intervention // Coronary Performs as best in class Bioabsorbable polymer for controlled drug release of a limus drug Proven PRO-Kinetic Energy / PK Papyrus stent design provides exceptional . The report provides comprehensive information on the pipeline products with comparative analysis of the products at various stages of development. 2. In order to inhibit coronary restenosis, and revascular- Of particular note was the association of these adverse events with the material, the polymer coating, and the active drug of currently approved drug eluting stents. Increased maximum expansion compared to other XIENCE Everolimus Eluting Coronary Stent System. In the mid 1990’s, drug-eluting metallic stents brought restenosis into the single digits, i. Claessen, MD,† Adriano Caixeta, MD,† Elias A. ISR formation is a multi-factorial, sequential process. As defined by section 503(g) of the Federal Food, Drug, and Cosmetic Act When multiple stents are required, stent materials should be of similar composition.


For drug-eluting stents, the time course of complete healing in humans is unknown. Drug eluting stents with durable polymer coatings significantly reduce late lumen loss and consequently reduce rates of target lesion and target vessel revascularization compared with bare metal stents and have revolutionized the practice of percutaneous coronary intervention. The Resolute Onyx™ drug-eluting stent is an advanced workhorse DES ready for your challenging coronary cases. This led to a bit of a panic, characterized by the NBC News report of drug-eluting stents as “tiny time bombs in your heart. XIENCE Sierra Everolimus Eluting Coronary Stent System (4. The US Food and Drug Administration (FDA) has approved Tryton Medical’s Premarket Approval (PMA) application for the Tryton side-branch stent for the treatment of coronary bifurcation lesions involving large-side branches (appropriate for a ≥2. 1. CORONARY DRUG ELUTING STENTS. The Food and Drug Administration (FDA) continues to feel that DES, when used according to approved indications The Medtronic Resolute Onyx™ Zotarolimus-Eluting Coronary Stent System (Resolute Onyx™ system) consists of a balloon-expandable, intracoronary, drug-eluting stent (DES) premounted on a Rapid Exchange (RX) or an Over-the-Wire (OTW) stent delivery system.


Slide 28: Drug Eluting stents in the Infrainguinal Circulation Machan L Techniques in Vascular and Interventional Radiology 2004; 7:28-32 Active Agents used in stent coating to prevent Restenosis Drugs Active Agents Immunosoppressive drugs Sirolimus ( rapamycin ) Everolimus ABT-578 FK506 ( tacrolimus With the introduction of balloon-expandable stents, coronary remodeling and, in turn, restenosis were reduced compared with angioplasty alone. Franziskushospital Münster 2- Centre of Vascular and Endovascular Surgery Universityhospital Münster Coronary Stents BY: COURTNEY MEDEIROS BME 281 11/30/11 Coronary Artery Disease Leading cause of death in United States for men and women Caused by buildup of plaque in arteries Heart tissue is deprived of nutrients Risk factors: Age Gender Genes Symptoms and Tests for Coronary Artery Disease Symptoms: Vary in strength Chest pain Fatigue Shortness of breath Weakness Tests: ECG Exercise Stress A second recurrence of in-stent restenosis within the proximal left anterior descending artery stent (Figure 1-5 and Video 1-4) was treated with a 3. If you continue browsing the site, you agree to the use of cookies on this website. 51 2 3 5 7 14 28 60 Days 90 180 Zotarolimus E-ZES (ng /mL) Zotarolimus in Arterial Tissue (in Stent) 25 Other 1 or 2 gen DES Zotarolimus-eluting Endeavor Sprint: hydrophilic polymer -based second-generation device with unique drug fast-release profile To report the long-term safety and efficacy data of a third generation drug eluting stent (DES) with biodegradable polymer in the complex patient population of diabetes mellitus after a follow-up period of 5 years. Drug-Eluting Stents vs. Schwindt1,2, G. 5 x 18 mm) n=5. increased risk of stent thrombosis, aneurysm, and further myocardial infarction) prevent the researchers to conclude whether drug-eluting or bare-metal stents are more effective in treating CAD Percutaneous treatment of complex coronary lesions, such as small-vessel disease, diabetes and long diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). throughout your body.


Coronary Stents BY: COURTNEY MEDEIROS BME 281 11/30/11 Coronary Artery Disease Leading cause of death in United States for men and women Caused by buildup of plaque in arteries Heart tissue is deprived of nutrients Risk factors: Age Gender Genes Symptoms and Tests for Coronary Artery Disease Symptoms: Vary in strength Chest pain Fatigue Shortness of breath Weakness Tests: ECG Exercise Stress The aim of this collection of activities is to help clinicians distill the data comparing the efficacy and safety of the various types of drug-eluting stents (DES). Bhatt, Samir R. Trial of Drug Eluting Stent Versus Bare Metal Stent to Treat Coronary Artery Stenosis (NORSTENT) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Singh, Peter Kelly, Deepak L. Wire re-crossing and dilatation of the SB with a balloon of diameter at least equal to that of the Treatment of Bifurcations with Drug-Eluting Stents (Hellenic Journal of Cardiology) HJC ñ 191 Figure 2. A drug-eluting stent is a device releasing into the bloodstream single or multiple bioactive agents that can deposit in or affect tissues adjacent to the stent. Angina treatment: Stents, drugs, lifestyle changes — What's best? Options for your angina treatment might include angioplasty and stenting, medications, or lifestyle changes. The Tryton Side Branch Stent, manufactured by Tryton Medical and distributed by Cordis, is now FDA-approved for use in the United States. Drug elution disrupts early inciting events that elicit restenosis, but once the drug is no longer present – typically after two to four weeks – the stent remains indefinitely.


The deflated balloon, catheter, and wire will be removed. Physicians talk about the importance of drug-eluting stents in complex lesions and how the Eluvia Drug-Eluting Stent is designed to deliver controlled, localized, low-dose amorphous paclitaxel to target lesions. Test performed by and data on file at Abbott. Brener We compared the safety of drug-eluting stents (DES) compared with bare-metal stents (BMS) in 699 We used search terms “stents”, “drug-eluting stents”, “percutaneous coronary intervention”, and “random*”. Boam, MSBE Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health What is a Drug-Eluting Stent (DES)? Example: Cordis Cypher Sirolimus-Eluting Coronary Stent. DHHS/FDA/CDRH In-Stent Restenosis in the Drug-Eluting Stent Era George D. A . 0 x 20 mm) n=5, Resolute Onyx Stent System (4. Components Stent Platform & Delivery System Carrier(s) Drug.


Kapadia, Stephen G. Drug-Eluting Stents Current Approach to Review Ashley B. Previously placed stent in target artery. Drug-Eluting Bioabsorbable Stents: Is This the Future of SFA and Popliteal Disease? LewisB. Drug Eluting Stent Drug Eluting Stents (DES) are coated with medication that is released (eluted) to help prevent the growth of scar tissue in the artery lining. However, with DES the need for repeat revascularization is reduced and our study contributes to the growing evidence that contemporary DES have a lower risk of stent thrombosis than BMS. Bare Metal Stents vs. 1,2 With the risk of restenosis still in the range of 15% to 20%, however, drug-eluting stents (DES) designed to release pharmacological agents after deployment were developed to inhibit the response to injury mainly responsible for restenosis after What lies ahead for new drug-eluting technologies? Clearly, there is a lot of interest in bioresorbable stents. Although the detailed mechanism of Drug Eluting Technology in Peripheral Interventions - authorSTREAM Presentation.


Zilver PTX Drug-Eluting Stent Mortality Analysis Michael D. Drug-eluting balloons (DEB) are conventional semi-compliant angioplasty balloons covered with an anti-proliferative drug which is released into the vessel wall during inflation of the balloon, usually at nominal pressures with a specific minimal inflation time. 27, No. Torsello1,2 1-Department of Vascular Surgery St. CAD Treatment Secondary prevention Lifestyle modification Diet, exercise, tobacco cessation Rx underlying risk factors Aspirin and ‘statin’ medications Anti-anginal medications Beta blockers Coronary Bypass Coronary Angioplasty Coronary Angioplasty Coronary Stenting Coronary Stenting Drug Stents Northwestern Memorial Hospital Cardiac At the recent European Society of Cardiology Congress 2005, I had the honor of co-chairing, with my colleague Prof. Sirolimus Eluting Coronary Stent System The new designed luer The transparent luer has a positive, tactile feel assisting in navigation of the system. Habraken , Wim E. INTRAVASCULAR IMAGING. 1 An estimated 600,000 coronary artery stents are placed annually in the United States for the management of acute and chronic The ISAR-DESIRE (Intracoronary Stenting or Angioplasty for Restenosis Reduction–Drug-Eluting Stents for In-Stent Restenosis) trial was the first randomized study assessing the value of DES in patients with BMS-ISR .


Over time, second- and third-generation metal stent designs further reduced restenosis. Approximately 40% of reported cases have occurred in the context of non-cardiac surgery (NCS) performed in patients with coronary artery stents, in whom dual antiplatelet therapy or clopidogrel alone has been ceased (2). Wash out is related to: Cardiac output vol/min HR x SV Concentration gradient Flow through the stent Length Diameter Turbulent flow vs laminar Unpredictable Sirolimus Eluting Coronary Stent System The new designed luer The transparent luer has a positive, tactile feel assisting in navigation of the system. This makes them less desirable for people with bleeding problems or those who'll need some type of surgery within a year after the stent is put in. Additionally, while drug-eluting stents may be more effective in reducing re-stenosis and the subsequent need for re-intervention, safety concerns (i. Cypher and Taxus stents were the first-generation drug-eluting stents. Drug-eluting Balloons. Schwartz,M. m.


However, the incidence of re-stenosis was still unacceptably high. Oliveria, Inder M. Coronary Arterial Drug-Eluting Stent: From Structure to Clinica l 199 unacceptably high (30%-60% in bare metal stents [BMSs] and 6%-18% in DESs) 7-9 despite DES implantation. Stents, and particularly drug-eluting stents, reduce the risk of restenosis, but may be associated with the hazard of late stent thrombosis. 5mm stent). Low to moderate risk for adverse events from carotid endarterectomy. But late stent thrombosis (LST) was being seen in patients who had been implanted with drug-eluting stents more than a year post-procedure. Ruiz‑Nodar4, Ralf Birkemeyer5, Jacques Monsegu6, Gérard Finet7, David Hildick‑Smith8, Damras Tresukosol 9, Enrique Garcia Novo10, diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). The Advisory will be published in the February 13, 2007 issue of Circulation.


In-Stent Restenosis in the Drug-Eluting Stent Era George D. Shishehbor, Reza Amini, Leonardo P. It was thought that the polymer was at fault. Recently, studies have indicated that this reduction in restenosis might have been obtained at the expense of a higher incidence of stent thrombosis, particularly late stent thrombosis. 4-year clinical outcomes and predictors of repeat revascularization in patients treated with new-generation drug-eluting stents: a report from the resolute all-comers trial (a randomized comparison of a zotarolimus-eluting stent with an everolimus-eluting stent for percutaneous coronary intervention). Ruiz‑Nodar4, Ralf Birkemeyer5, Jacques Monsegu6, Gérard Finet7, David Hildick‑Smith8, Damras Tresukosol 9, Enrique Garcia Novo10, been powered to assess stent thrombosis. increased risk of stent thrombosis, aneurysm, and further myocardial infarction) prevent the researchers to conclude whether drug-eluting or bare-metal stents are more effective in treating CAD Coronary Arterial Drug-Eluting Stent: From Structure to Clinica l 199 unacceptably high (30%-60% in bare metal stents [BMSs] and 6%-18% in DESs) 7-9 despite DES implantation. Panuccio2, G. Sanidas, MD,† Gary S.


3,4 DESs effectively reduce neointimal proliferation and rates of angiographic restenosis; however, the same drugs delay stent endothelialization,5,6 thus potentially prolonging the period where the DES is at higher risk for stent thrombosis. There are two types of stents: bare-metal stents (BMS) and drug-eluting stents (DESs). Bare-Metal Stent Restenosis Drug-Eluting Stent Restenosis Imaging features stent subsequently deployed in the MB flattens the pro-truding cells of the SB stent, hence the term “crushing” or “crush”. The advent of drug-eluting stent (DES), especially 2nd generation, and drug-coated balloon (DCB) further reduce restenosis rate until <10%. Coronary angioplasty - also known as percutaneous transluminal coronary angioplasty The stent will be left in place to hold the vessel walls open. Federal Government. Bare Metal Stents In Saphenous Vein Graft Angioplasty (DIVA) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Drug-Eluting Balloons Klaus Bonaventura Department of Cardiology and Angiology Heart Thorax Vascular Center, Klinikum Ernst von Bergmann, Potsdam Drug-Eluting Stent What lies ahead for new drug-eluting technologies? Clearly, there is a lot of interest in bioresorbable stents. Whitlow, Sorin J.


Introduction of drug eluting stents (DES) reduced this problem dramatically (1,2). Recent guidance has been updated to reflect improved outcomes after second-generation drug-eluting stenting, but a standard duration for all patients is not rational given the different risks for ischemic and bleeding complications. by. DESolve ® NOVOLIMUS™ Eluting Bioresorbable Coronary Scaffold System. its Resolute Onyx drug-eluting (zotarolimus) stent. Drug-Eluting Stents for STEMI: Is it Settled? Ajay J. Different Coronary stent design PPT 1. Hennink , and Robbert J. Stents implanted during index PCI was everolimus-eluting stent (EES) in 47%, paclitaxel-eluting stent (PES) in 27%, zotarolimus-eluting stent (ZES) in 13%, sirolimus-eluting stent (SES) in 11%, and multiple in the others.


The DESolve Scaffold System is one of Elixir Medical’s latest advancements - a state-of-the-art novolimus-eluting bioresorbable coronary scaffold system that represents the next generation in scaffold technology. Non-stent-based strategies of local drug delivery at the treated coronary segment have been investigated for some years in order to reduce the exaggerated neointimal response to mechanical injury. The makers of drug-eluting stents have agreed that compared with bare-metal stents there is a small, but significant increase in the rate of stent thrombosis for both the Cypher (sirolimus-eluting) and Taxus (paclitaxel-eluting) stents, beginning about 12 months after implantation. Coronary angioplasty - also known as percutaneous transluminal coronary angioplasty In a trial involving over 9000 patients with coronary artery disease who were assigned to receive either contemporary drug-eluting stents or bare-metal stents, there was no significant between However, neointimal hyperplasia occurring within the stent leading to in-stent restenosis is a main obstacle in the long-term success of percutaneous coronary intervention (PCI). WITH the advent of percutaneous coronary intervention (PCI), specifically the bare-metal stent (BMS) and subsequently, the drug-eluting stent (DES), the role of interventional cardiology in coronary revascularization has greatly increased. A second recurrence of in-stent restenosis within the proximal left anterior descending artery stent (Figure 1-5 and Video 1-4) was treated with a 3. '' Coronary stents are implantable devices that are placed percutaneously in one or more coronary arteries to maintain patency. 2016. • The DAPT Study was designed in response to a request from the FDA to evaluate the effect of dual antiplatelet therapy beyond one year in subjects treated with coronary stents.


Approximately two thirds of the patients received clopidogrel, whereas the rest received prasugrel. Columbus, OH Drug Release (%) E-ZES Drug Elution Kinetics 30 20 15 10 5 0 0 0. Table 1: Comparison of Principal Features of Restenotic Tissue after Bare Metal and Drug-Eluting Stent Implantation. Drug Eluting Stents (DES) by Carol Ongwenyi Mariam Israiel Rasha Ereifej Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Dual Antiplatelet Therapy-DAPT. Gitt, a fascinating session on stent thrombosis and drug-eluting stents (DES 1. The Resolute Onyx™ stent is manufactured from a composite material of cobalt alloy and Approximately two thirds of the patients received clopidogrel, whereas the rest received prasugrel. 14 Expectations were met, with promising results obtained with drug-eluting balloons at both bench and bedside. Coronary artery stenting is the treatment of choice for patients requiring coronary angioplasty.


The core question is whether they will emerge, in the end, as a great boon to coronary patients or as a letha –PCI w/drug eluting stent •Double vs triple antithrombotic therapy –Anticoagulant + aspirin or ADP inhibitor –Atrial fibrillation + drug eluting stent 15 Khumbani, D. -- The issues surrounding drug-eluting coronary stents remain white hot. Learn the cardiovascular risk of modifying antiplatelet therapy in the peri-endoscopic setting current status of drug eluting balloons for sfa/pop intervention. Senior Vice President of Health Sciences Professor of Medical Imaging, Medicine, and Surgery University of Arizona Tucson/Phoenix, Arizona GlobalData's Medical Devices sector report, "Drug Eluting Stents (DES) - Medical Devices Pipeline Assessment, 2018" provides an overview of Drug Eluting Stents (DES) currently in pipeline stage. Brener We compared the safety of drug-eluting stents (DES) compared with bare-metal stents (BMS) in 699 Introducing the EluNIR Coronary Stent System, the next generation in drug-eluting stent technology. Senior Vice President of Health Sciences Professor of Medical Imaging, Medicine, and Surgery University of Arizona Tucson/Phoenix, Arizona FDA is announcing the availability of a draft guidance for industry entitled ``Coronary Drug Eluting Stents--Nonclinical and Clinical. 1 However, first generation durable polymer drug eluting stents have been associated with an increased Medtronic won FDA regulatory approval and is releasing in the U. diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). Metallic stent technology has been at the forefront of this catheter-based treatment revolution.


Kirtane, MD, SM Columbia University Medical Center / New York Presbyterian Hospital coronary stent implanted; Self-expanding 1998 EPISTENT shows significant benefit of ReoPro® with stenting First fully bioabsorbable drug eluting stent pp p implanted in humans stents stainless steel wire mesh implanted in canine coronary arteries Sejong General Hospital Objective The superiority of drug-eluting stents (DES) over bare-metal stents (BMS) in patients with ST elevation myocardial infarction (STEMI) is well studied; however, randomised data in patients with non-ST elevation myocardial infarction (NSTEMI) are lacking. The safety and effectiveness of the Xact Carotid Stent System has NOT yet been established in patients with the characteristics noted below. AP2946391-WBU Rev. A prospective randomized trial of drug-eluting balloons versus everolimus-eluting stents in patients with in-stent restenosis of drug-eluting stents: the RIBS IV randomized clinical trial J Am Coll Cardiol, 66 (2015), pp. Drug can be simply linked to the stent surface, embedded and released from within polymer materials, or surrounded by and released through a carrier. This part review recommends under what circumstances a drug-eluting stent should be used. Current & Future Stent Design for Drug-eluting Stent-Focused on the Updated Resolute Program - Seung‐Woon Rha, MD, PhD, FACC, FAHA, FESC, FSCAI, FAPSIC Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea The ISAR-DESIRE (Intracoronary Stenting or Angioplasty for Restenosis Reduction–Drug-Eluting Stents for In-Stent Restenosis) trial was the first randomized study assessing the value of DES in patients with BMS-ISR . To date, head-to-head comparisons are missing. Taniwaki M, Stefanini GG, Silber S, et al.


Downside of metallic stents. and European markets. 1 and 1. 14 Balloons In the pre-stent era the occurrence of restenosis ranged between 32–55% of all angioplasties, and drop to successively 17–41% in the bare metal stents (BMS) era. The Drug-Eluting Revolution and the Evolution of a Dynamic Market A comparison of stent strut thickness between the Orsiro stent, pictured, and the market-leading stents on the U. Studies. Trials were included if at least 90% of patients in the DES group received new-generation stents. The introduction of BMS significantly reduced the frequency of symptom recurrence and repeat procedures due to stent re-stenosis by comparison with angioplasty. When multiple stents are required, stent materials should be of similar composition.


Working Subscribe Subscribed Unsubscribe 6K. 23-33 Zilver PTX Drug-Eluting Stent Mortality Analysis Michael D. The recent introduction of drug-eluting stents (DES) contributes a major breakthrough to interventional cardiology. Introducing the EluNIR Coronary Stent System, the next generation in drug-eluting stent technology. Braun has developed PACCOCATH technology which uses a spacer between Paclitaxel molecules to create a matrix coating on the balloon. In order to inhibit coronary restenosis, and revascular- View the Spanish translation and Factoid for this article Download this article's Factoid in PDF (& PPT for Gold Subscribers) Late adverse events—namely stent thrombosis and target lesion revascularization (TLR)—persist at low levels with first-generation drug-eluting stents (DES) out to 5 years, a concerning trend that needs to be addressed by newer stent designs, according to the authors coronary stent implanted; Self-expanding 1998 EPISTENT shows significant benefit of ReoPro® with stenting First fully bioabsorbable drug eluting stent pp p implanted in humans stents stainless steel wire mesh implanted in canine coronary arteries Sejong General Hospital A prospective randomized trial of drug-eluting balloons versus everolimus-eluting stents in patients with in-stent restenosis of drug-eluting stents: the RIBS IV randomized clinical trial J Am Coll Cardiol, 66 (2015), pp. 1 However, first generation durable polymer drug eluting stents have been associated with an increased Mechanism of Controlled Release Kinetics from Medical Devices 213 Brazilian Journal of Chemical Engineering Vol. drug eluting stent ppt

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