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News About Stents and PCI

Dr. Etsuo Tsuchikane
Complex CTO-PCI: The Japanese Approach
This 20 minute video shows a complex CTO case, in which an RCA obstruction, complicated by a sharp bend and tortuous anatomy, was revascularized using both the antegrade and retrograde approaches, facilitated by IVUS and biplane angiographic imaging. The operator is Dr. Etsuo Tsuchikane; the case was broadcast live during the Japanese CTO Club course in June 2017. (from TCROSS NEWS)
DAPT Study: Extended Treatment After Stenting Lowers Stent Thrombosis and Heart Attacks
Stent and pills
"Longer is better." That's what Dr. Dean Kereiakis told Angioplasty.Org when characterizing the results of the long-awaited Dual Antiplatelet Therapy (DAPT) study, which were presented today at the annual American Heart Association Scientific Sessions in Chicago. Dr. Kereiakes is the co-principal investigator for this five year study of 10,000 patients, which adds to the knowledge base of whether long-term treatment with aspirin and a thienopyridine, such as Plavix, after stent implantation is beneficial to patients.
Will a Denial of Service DOS Attack Hit New York State Medicaid Patients? Or Perhaps Your State?
DOS Attack on Stents
What does a Denial of Service Attack have to do with stents, angioplasty and PCI? In the world of computing, a DOS attack is defined as "an attempt to make a machine or network resource unavailable to its intended users." Now it seems similarly that in New York State, cardiovascular treatments may become unavailable to some Medicaid patients: a denial of service. (read more)
ZEUS: Drug-Eluting Stent Outperforms Bare Metal for Safety and Efficacy in At-Risk Patients
The ZEUS trial of 1,606 patients showed that the use of Medtronic's Endeavor zotarolimus-eluting stent is associated with a lower risk of major cardiac events at one year compared to bare metal stents among a patient population normally excluded from treatment with drug-eluting stents. (read more)
DUTCH PEERS: Resolute Integrity vs. Promus Element 3rd Generation Stents
Medtronic's Resolute Integrity and Boston Scientific's Promus Element
Are 3rd generation drug-eluting stents interchangeable? And what exactly is a "third generation" drug-eluting stent anyway? These were questions addressed by the DUTCH PEERS randomized clinical trial. The results showed that the Resolute Integrity was non-inferior to the Promus Element. There was, however, one parameter in which the two stents were not the same: longitudinal stent deformation.(read more)
Medtronic Stent Data for Diabetic Patients Published
Resolute Integrity DES
This week JACC: Cardiovascular Interventions published an article detailing the two-year pooled analysis of outcomes from Medtronic's international RESOLUTE Global Clinical Program of over 5,100 patients: how this data showed positive results for the interventional treatment of patients with diabetes, and how these outcomes led the FDA to approve the Resolute Integrity for use in diabetic patients. (read more)
Abbott Launches Disappearing Stent: the Absorb™ Bioresorbable Vascular Scaffold
Starship Stenterprise
Abbott Laboratories has launched Absorb™, the world's first drug-eluting bioresorbable vascular scaffold (BVS) and it will now be available across Europe and parts of Asia Pacific and Latin America. Absorb received the CE Mark approval back in January 2011, but the disappearing stent, or "scaffold" as the company calls it, was not widely distributed until now. (read more)
Drug-Eluting Stents Are Safe
Drug Eluting Stents
Three year results from the largest randomized clinical trial of drug- eluting stents ever conducted, and the only trial sufficiently powered to measure stent thrombosis, show low rates of blood clots occurring inside drug- eluting stents implanted in "real-world" patients. What makes this study important is the very large number of patients: over 8,700 at 196 centers in 36 countries across five continents. (read more)
Interviews with the Experts
Dr. B. Clay Sizemore
Optimizing Stent Expansion with Intravascular Lithotripsy Safely in a Hospital Without Surgical Backup
IVL has made it possible to treat calcified lesions safely in hospitals that do not have surgical backup. Dr. B. Clay Sizemore discusses how he has reduced the number of patients that need to be transported an hour away.... (read more)
Masanori Yamamoto, MD
Validating the DAPT Score in a Large Pooled Cohort from 3 Japanese Studies
In light of the recent approval of Medtronic's CoreValve Evolut R, Dr. Masanori Yamamoto discusses the current landscape of TAVR devices in Japan.... (read more)
Masanori Yamamoto, MD
Clinical and Market Impact of New Generation TAVR Devices in Japan
In light of the recent approval of Medtronic's CoreValve Evolut R, Dr. Masanori Yamamoto discusses the current landscape of TAVR devices in Japan.... (read more)
Hiroki Shiomi, MD, PhD
Routine Angiographic Follow-up After PCI?
Dr. Hiroki Shiomi discusses the ReACT study from Japan which tested whether routine angiographic follow-up resulted in better outcomes than routine clinical follow-up.... (read more)
Paul S. Chan, MD, MSc
PCI Appropriateness Criteria Misunderstood
Dr. Paul Chan sets the record straight on Appropriateness of PCI in the U.S.. He explains the significance of his new study of a half-million patients, recently published in JAMA.... (read more)
Ralph Brindis, MD, MPH, FACC
Measuring and Managing Appropriateness
American College of Cardiology immediate past president Dr. Ralph Brindis discusses the National Cardiovascular Data Registry (NCDR) and weighs in on the recent study of PCI Appropriateness.... (read more)
Alan Yeung, MD
Testing a New Drug-Eluting Stent?
Dr. Alan Yeung, principal investigator of the RESOLUTE US study, discusses trial design and polymer elution outcomes for the RESOLUTE stent.... (read more)
Sanjay Patel, MD FACC
Is 90 Days of Dual Antiplatelet Therapy Enough?
Dr. Fausto Feres is conducting a new trial in Brazil, testing whether 3 months of dual antiplatelet therapy after placement of an Endeavor DES may be sufficient. Dr. Feres discusses the OPTIMIZE Trial of 3,200 patiients... (read more)
Sunil V. Rao, MD, FACC
Genomics Could be Key to Individualizing Antiplatelet Therapy
In this interview, Dr. Eric Topol, Director of the Scripps Translational Science Institute, discusses his work in genomic studies of patients' antiplatelet responsiveness and its implications in determining the optimal duration of dual antiplatelet therapy.... (read more)
Jennifer Tremmel, MD
Drug-Eluting Stents: Current Usage and Future Trends
Dr. David Kandzari has been on staff as an interventional cardiologist in several major medical centers and has also served as chief medical officer for Johnson & Johnson/Cordis. He shares his views of the current status of drug-eluting stents in the U.S. and what he sees are the big issues for the future.... (read more)
First Thoughts About Drug-Eluting Stents
Dr. Gregg Stone is Director of Cardiovascular Research and Education at New York-Presbyterian Hospital / Columbia University Medical Center. He discusses the basics of drug-eluting stents, from an interview done just after the Taxus DES was first approved.... (read more)
This special section is supported by an unrestricted educational grant from:
Medtronic Inc.
Visit Medtronic's Website for More Information on Stents and Other Pioneering Therapies
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Stent News: Reports and Features
Breaking news, original reporting and links to research about drug-eluting stents:
•  All Drug-Eluting Stents News
DUTCH PEERS: Are Resolute Integrity & Promus Element Stents Equivalent? (Feb 11)
Medtronic Stent Data for Diabetic Patients Published (Apr 18)
FDA Panel Recommends MitraClip for Approval (Mar 20)
No Stent Thrombosis Seen When Plavix and Aspirin Stopped Early (Mar 13)
Medtronic Stent Gets CE Mark Label Update for One Month of DAPT (Mar 4)
Drug-Eluting Stent Overview
drug-eluting stents
Drug-eluting stents (a.k.a. "coated" or "medicated" stents) were developed to solve one of the biggest problems of percutaneous interventional coronary treatment: restenosis -- reblocking or reclosure of the artery.... (read more)
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Sunil V. Rao, MD, FACC
Quote of the Month
"...the COURAGE trial ...implied that maybe 70% or more of angioplasty is for stable angina in the United States...and that simply is not true! Well over 70% of all angioplasty in the United States is for acute syndromes."
-- Ralph Brindis, MD, MPH, FACC
Past President of the American College of Cardiology
Senior Advisor for Cardiovascular Disease
for Northern California Kaiser
Clinical Professor of Medicine
University of California, San Francisco
Learning from Patients:
Patient Forum
Angioplasty.Org hosts a Patient Discussion Forum for topics in interventional cardiology. And we get many posts from patients: some who are back to leading active lives; some who may be having problems post-procedure. While these postings represent a small percentage of all PCIs performed, it is instructive to read these stories.
•   Comments from patients who are not feeling well after stenting -- sometimes it's the new medications, sometimes it's another issue.
•   Questions about how long to take aspirin and Plavix or other antiplatelet medications. There is much confusion among patients about the proper duration of DAPT.
•   Stent patients who are having surgical procedures or dental work are often told they must stop their antiplatelet therapy -- and they write into The Forum.
•   Patient discussions about Exercise, Sport, Physical Activity After Stent
A Patient's Experience:
"It's great to hear of everyone's victories recovery-wise, both major and minor. I had 3 coronary stents in Nov 2010...and the cardio told me exercise as I wish. So, two 10km running races and a half-marathon completed since the stents went in, and I'm now training for triathlons! I quit smoking and have lost over 10kgs and work out about an hour each day. I tell you all this because I'm so impressed by the medical intervention and how it can turn around our lives. The angina before I was diagnosed was agonising and I couldn't even walk 100 metres! Best of luck to everyone undergoing angio and stenting!" -- as posted by DavidJ, March 21, 2011 in Angioplasty.Org's Patient Forum on "Exercise, Sport, Physical Activity After Stent"