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Warren K Laskey

Publications and source records attributed to Warren K Laskey.

41 records · Page 3Linked to original sources
PubMed2002

Assessment of contemporary stent deployment using intravascular ultrasound.

Four second- and third-generation coronary stents were evaluated using QCA and intravascular ultrasound for adequacy of stent expansion, the influence of disease burden on adequacy of deployment, and postdeployment structural effects on the artery. Despite satisfactory stent deployment rates on angiography of 92 %, adequate stent deployment by IVUS ranged from 38% to 55%. There was no significant difference in deployment success across the four stent types. Lesions with significant plaque burden were associated with a lower rate of deployment success (P = 0.04). Twenty-one edge dissections were demonstrated by IVUS; only six were detected by angiography. Observations made on first-generation stents regarding adequacy of deployment still hold true for newer-generation stents. Significant plaque burden is an independent negative predictor of stent deployment success. The presence of IVUS-detected edge dissections indicates that the extent of injury during PCI extends beyond the physical length of the stent.

Adult↗
PubMed2002

Angina 1 year after percutaneous coronary intervention: a report from the NHLBI Dynamic Registry.

BACKGROUND: As percutaneous coronary intervention (PCI) is most commonly performed for relief of angina, it is important to identify factors associated with recurrence of anginal symptoms. METHODS: We examined symptoms at 1-year follow-up in 1755 consecutive NHLBI Dynamic Registry patients who underwent PCI in the setting of symptoms or acute infarction. RESULTS: At 1-year follow-up, 26% of patients reported angina in the previous 6 weeks. Younger patients and females reported more symptoms. History of coronary artery bypass graft (CABG) or PCI, prior myocardial infarction (MI), diabetes, graft disease, and extensive coronary artery disease (CAD) (>4 significant lesions) were also associated with follow-up angina. Patients receiving stents reported less angina (24% vs 29%, P <.05). Completely revascularized patients and those with residual single-vessel disease had comparable 1-year angina rates (23% both subgroups), while 32% of patients with residual multivessel CAD reported symptoms. Patients undergoing repeat PCI during follow-up reported more 1-year angina than others (34% vs 24%, P <.001), whereas those undergoing CABG after post-PCI hospitalization had less symptoms (15% vs 26%, P <.05). After adjustment for baseline symptom status and outcome of index PCI, residual CAD, and reintervention during follow-up, patient characteristics significantly predictive of angina included female sex, age <62 years, and prior MI. CONCLUSIONS: While approximately three quarters of patients receiving PCI are angina-free at 1 year, females continue to have more symptoms, as do other subgroups including patients with history of MI or previous intervention. As these symptoms are associated with self-reported activity and quality of life limitation, evaluations of PCI should include angina as a key follow-up outcome.

Age Factors↗
PubMed2000

Debate: When should we intervene in unstable angina - Time for an old look?

Current treatment modalities for patients with acute coronary syndromes center on early diagnosis, risk stratification and, increasingly, early treatment including invasive approaches. The appropriate timing of these invasive modalities in the context of the overall treatment program remains an area of controversy. Specifically, studies in the past recommended a period of medical 'stabilization' while current approaches are considerably more aggressive. The potential hazard of early intervention, in particular, has not properly been weighed against the benefit. This article hopes to provide a framework for examining the appropriate timing of intervention, specifically percutaneous coronary intervention, in acute coronary syndromes.

Journal Article↗
PubMedDate not supplied

Cardiovascular device development: drug-eluting stents and implantable devices for the treatment of heart failure--the view from the Circulatory System Advisory Panel.

The development of sirolimus and paclitaxel-eluting stent delivery systems proved successful in reducing restenosis rates to single digit levels compared to bare metal stents, although the long-term safety of the latter devices was not assessed in these premarket applications. Implantable devices for the treatment of patients with advanced congestive heart failure improved short-term measures of circulatory function but underscored the role of properly conducted randomized controlled clinical trials. All of these examples highlight the critical role of valid scientific evidence in the regulatory process for cardiovascular device development.

Advisory Committees↗