Sirolimus-coated Stent Prevents Neointimal Proliferation.
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Biomedical subjects
Patrick W. Serruys
Publications and source records attributed to Patrick W. Serruys.
Recent Developments in Coated Stents.
Next to optimizing of stent properties and profile, coating has been thoroughly investigated over the years to enhance hemocompatibility and tissue compatibility, not only in straight forward lesions, but also in smaller vessels and long and complex lesions. This is even more important because it is has become clear that treatment of restenosis and especially in-stent restenosis still has poor results, and the best way to diminish these refractory restenotic lesions is its prevention. Ongoing trials with new drug-eluting stents (including rapamycin) may introduce a new era of improvement.
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Three-Dimensional Myocardial Perfusion Maps by Contrast Echocardiography.
We evaluated the clinical applicability of a system for three-dimensional (3-D) display of a perfusion map following myocardial contrast echocardiography (MCE). The system was used in 12 patients (9 males and 3 females, mean age 52 +/- 10 years) undergoing interventional treatment of chronic total coronary occlusion. In each patient three standard apical views were acquired at baseline with sonicated Iopamidol(R) injections into the left coronary artery (LCA) and into the right coronary artery (RCA). Following successful recanalization of the occluded artery MCE was repeated. The patients tolerated the procedure well. Acquisition of three standard apical views provided sufficient information for the reconstruction of 3-D perfusion maps containing the 16 standard left ventricular (LV) segments. Side-by-side display of the perfusion maps obtained following LCA and RCA echocontrast injections allowed us to classify the myocardial segments (192) into three groups: (1) those supplied by one major artery (124); (2) those supplied by collaterals from contralateral or both major arteries (58); and (3) segments supplied by none of the major arteries (10). Decreased opacification was observed in 50 segments of group 2. Following successful intervention we were able to visualize the redistribution of blood flow delivered to the LV myocardium by each major coronary artery in 3-D format. We conclude that this 3-D approach, which can easily be performed with currently available ultrasound equipment, allows an estimate of the contribution of each major coronary artery to LV perfusion before and after coronary angioplasty.
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