the debate focused discusses four types of support: application in dimension mo company, paclitaxel or assist him mo company's drug-eluting stents, and bare metal stents, the latter in PCI therapy options still holds a place.
Indianapolis, indiana St. Vincent heart center's Jim b. dr Hermiller in dimension mo company (des EES) curative effect is better than other stents puts forward related reason, because the stents more suitable for more small, vascular lesions is longer and more complex patients condition. He said: & ldquo; These subtle differences may cause patients later in reascularization rate produced on great differences.
it from the structure, in accordance with the dimension of the mughal company support rod thickness of smaller than other stents. Hermiller said dr & ldquo; We know, traditional data show that the strut bar the thinner stent, endothelial cell cover these support bar the greater their chances of & rdquo; . He points out that animal studies indicate that, in use in dimension when the stent mughal company than other stent endothelial cell coverage drug-eluting stents are high, and the almost with bare metal stents coverage equivalent. Animal research has shown that, in dimension mo company stents contain fluorination triggered the risk of blood clots adhesion copolymer scaffolds also lower than others.
XIENCE V EES test Hermiller the main researchers dr survival IV test (N reference Engl J Med J J J 362:117; 2010 74) data indicated that the application EES bracket 1 year target lesion failure rate is paclitaxel-eluting stents (PES) lower (except diabetic patients outside). He said, EES and PES stent in other aspects of the results is similar.
Hermiller said dr & ldquo; No definite division sign PES stents significant EES stents better, however, if fully from the opposite into consideration, when applied to people without diabetes, compared with PES stents EES stents for patients, the benefits brought about profound rdquo; and . He said, based on the related ENDEAVOR IV test result, EES stents also better than with his mo company (des ZES), the study found application PES and ZES stents made similar results.
New York Presbyterian hospital Dangas Georges retort said, however, dr ZES stents (Resolute, beauty, force in cardiovascular events) than other types of stents more advantages. ZES stents in to sirolimus (SES) des comparative study of ENDEAVOR III trials, has been accumulated five years of available data (JACC Cardiovasc. Interv. 2009; 2:11 99-207). Dangas said dr & ldquo; The difference between the original has been over time gradually narrowing, application with his mo company of des patients for clinical outcome better & rdquo; .
he said, moreover, ENDEAVOR IV test (the test ZES and PES stents to makes a comparative study) 3 years, according to the results of the PES groups of patients died prematurely in myocardial infarction (MI) chance ZES groups of patients is almost twice (7.1% to 3%).
Resolute All Comers research (a into the 2,292 patients randomized clinical trials, the result in May this year EuroPCR meeting in published the results indicated that the application) in accordance with the sauce and assist him good vascular mo company des got similar clinical results. Dangas said dr & ldquo; In one year later, the researchers found application with his mo company stents stent thrombosis in induced in a slightly higher risk of death, but has a slightly lower in. & rdquo; He added that in and bare metal stents (BMS) when comparing ZES stents, study confirms application of patients more low, and MI incidence appeared in the first five years after patients with vascular restenosis of 16.5 percent chance of 7% stent (BMS).
st John Barnes - the Jewish hospital said dr m. Lasala, meanwhile, the study also made clear paclitaxel-eluting stents (PES) (Taxus Liberté, Boston scientific) in the coronary arteries restenosis after interventional treatment in the field of this particular status. Said dr & ldquo Lasala; This is a listing of 18 before research and 11 after the institute for listed the longest follow-up study one of these studies, total record into more than 46,000 patients. & rdquo;
he said that in the past several years, aimed at PES stents and other DES system research both came to similar results. Dr Lasala report said, however, to assist him stents and PES stent system mainly mughal company differs after angioplasty, its inner diameter reduced late stent vessels this index are more likely to occur on the low drift. He said: & ldquo; These two kinds of drug-eluting stents in happen this index diameter reduced blood exist on a notable difference, this conclusion does not exist any dispute, but researchers in the first 2 years found that, in some participate in the study angioplasty and groups of patients, patients with application PES stents in stable condition, and application with his mo company stents in patients in a vessel diameter reduced aspects on the benefits reduced & rdquo; . Similar deviation in other study has confirmed. Said dr & ldquo Lasala; So obviously have some causes the drift. & rdquo;
he said, moreover, polymer-based paclitaxel-eluting stents for diabetic patients produced better clinical outcomes, this is a very important check, because in need to undertake coronary revascularization patients, one third of patients will develop diabetes. Said dr & ldquo Lasala; PES stents are randomized clinical trials in the most support, to study the stent for five years in a follow-up study show that the stents seems very durable and predictability is admirable, and its not in a late this index diameter reduced blood vessels occur on to, and we in drift observing other types of DES time-averaged found this phenomenon. The stents in the treatment of patients with diabetes, and existing advantage when used in patients with end-stage renal disease, the advantage may also exist. & rdquo;
Washington, Washington hospital center Pichard Augusto d., said dr already widely used even DES, but stents length is still support applications bare metal stents one of elements. He said: & ldquo; Short stents more advantages. & rdquo;
Pichard doctor support applications ldquo; execute & BMS stents Pointlike rdquo; stent placement & . He said: & ldquo; The longer the length stent, vascular restenosis and thrombosis, the greater the chance after stent placement, blob-shaped for the bypass surgery may provides the convenience. & rdquo; He said, applied pointlike stents appear stents vascular restenosis edge; chance & lt 2%.
he summarized the application short stents BMS happen stents edge of vascular restenosis four possible: adverse reconstruction, intimal proliferation, patch load & lt; 50% advance and what happens when the balloon expanded. In multivessel coronary artery disease patients with application of blood reserves scores of angiography guide PCI comparison test (j. Coll. J Cardiol. J Am doi: 10.1016/[J]) 2010.04.012 j.j acc, according to the already inserting a stent in patients with more effective use of drugs.
Pichard said dr & ldquo; Where possible all should avoid using very long stents, for long lesions and stent placement concerned, blob-shaped may be a better choice. & rdquo;
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