• Title/Summary/Keyword: Coronary restenosis

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A Novel Deposition Method of PLGA Nanoparticles on Coronary Stents

  • Joo, Jae-Ryang;Nam, Hye-Yeong;Nam, So-Hee;Baek, In-Su;Pakr, Jong-Sang
    • Bulletin of the Korean Chemical Society
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    • v.30 no.5
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    • pp.1085-1087
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    • 2009
  • Bare metal stents which were used to treat coronary artery disease have several biochemical problems. Polymerbased drug-eluting stents (DES) have opened up a new paradigm in the treatment of in-stent restenosis. Many studies and research programmes have proved that DES can prevent restenosis. In our study, paclitaxel-loaded poly (lactic-co-glycolic acid) (PLGA) nanoparticles have been deposited along the three dimensional scaffold of coronary stents by a method using self-assembling properties of colloidal particles. We found that the nanoparticles were deposited uniformly and closely packed. The amount of paclitaxel was easily controlled by the drug content of the nanoparticles and the deposition count.

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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Coating defects in polymer-coated drug-eluting stents

  • Bedair, Tarek M.;Cho, Youngjin;Park, Bang Ju;Joung, Yoon Ki;Han, Dong Keun
    • Biomaterials and Biomechanics in Bioengineering
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    • v.1 no.3
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    • pp.131-150
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    • 2014
  • Vascular stenting has a great attention as a treatment for coronary arteries diseases as compared with percutaneous balloon angioplasty. In-stent restenosis and thrombosis are side effects resulting from using bare metal stent (BMS). Employing platelet therapy allowed to reduce the rate of thrombosis, however, the rate of restenosis remains a major problem. In 2002, drug-eluting stents (DESs) were introduced as an effort to reduce the restenosis. The commercially available DESs continue to suffer from coating defects that might lead to a series of adverse effects. Most importantly, multiple concerns remain regarding the polymer coating integrity on metal surfaces or the relation of polymer irregularities to longterm adverse events.

Effects of the Geometric Dimensions on the Hemodynamics of Aorto-Coronary Bypass (Aorto-Coronary Bypass의 기하학적 형상이 관상동맥의 혈류특성에 미치는 영향)

  • Suh, S.H.;Roh, H.W.;Yoo, S.S.;Kwon, H.M.;Kim, D.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.254-257
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    • 1996
  • An aorto-coronary bypass graft is frequently adopted for the interventional therapy of the diseased atherosclerotic coronary artery grafting. The bypass artery is often occluded due to restenosis and/or anastomotic neointimal fibrous hyperplasia after bypass graft. The optimal aorto-coronary bypass procedure must be studied in order to improve patency rate for the arterial bypass techniques. The objective of this study is to investigate the influences of geometric dimensions of bypass on the hemodynamics around the anastomosis in the stenosed coronary artery with aorto-coronary bypass.

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Numerical Evaluation and Shape Design of Coronary Artery Stent (관상동맥혈관용 스텐트의 수치해석 및 형상 설계)

  • Kim, Dae-Young;Lee, Seung-Yeol;Kim, Heon-Young
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.1
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    • pp.103-108
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    • 2012
  • Restenosis symptom, which is well known as a problem of stents, is due to the recoil and expansion pressure depending on shapes of stent. In order to reduce the effect of recoil problem, study on pattern and shape for the stent is required and the expansion pressure and recoil should be evaluated. This paper aims at evaluating mechanical characteristics of stent used in surgery for vessel stenosis. The expansion process of coronary artery stent in vessel for two models including the Cypher$^{(R)}$ from Johnson & Johnson$^{TM}$ and a suggested model were simulated using the Finite Element Analysis. Comparison of the directional recoil simulation results was made. The issues in the deformed shape of vessel and recoil of Cypher$^{(R)}$ were partially resolved in the suggested model. Therefore, the shape design suggested in this paper was able to reduce the restenosis symptom.

Spontaneous resolution of new coronary artery aneurysm following guideline-directed medical therapy after drug-eluting stent implantation

  • Jae-Geun Lee;Ki Yung Boo
    • Journal of Medicine and Life Science
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    • v.20 no.3
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    • pp.131-134
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    • 2023
  • Here, we present a case of a 56-year-old man with acute myocardial infarction. The patient underwent percutaneous coronary intervention (PCI) at the left main bifurcation and mid-left anterior descending artery using drugeluting stents. Four months after the PCI, the patient was readmitted for cardiac arrest. Coronary angiography (CAG) revealed stent thrombosis in the left main-to-proximal left anterior descending artery and in-stent restenosis in the left main-to-proximal left circumflex artery. We performed balloon angioplasty at the left main to mid-left anterior descending artery and left main to proximal left circumflex artery stents; subsequently, blood flow was fully restored. However, contrast agent extravasation was observed outside the mid-portion of the left main artery to the proximal left anterior descending artery stent, indicating the presence of a coronary artery aneurysm (CAA) outside the stent. After guideline-directed medical therapy with dual antiplatelet agents and high-intensity statins, follow-up CAG revealed near-resolution of the CAA, absence of stenotic lesions, and good blood flow.

Sequential Bypass Effects in the Stenosed Coronary Artery (협착이 발생된 관상동맥내 시퀜셜 문합의 효과)

  • Roh, Hyung-Woon;Suh, Sang-Ho;Kwon, Hyuck-Moon;Lee, Byung-Kwon
    • Proceedings of the KSME Conference
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    • 2003.04a
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    • pp.1919-1922
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    • 2003
  • Bypass anastomosis are frequently adopted for surgical treatments. After the bypass grafting, the bypass artery is often occluded due to restenosis and/or anastomotic neointimal fibrous hyperplasia phenomena. Optimal coronary bypass anastomosis should be investigated to improve the patency for the arterial bypass techniques. The objective of this study is to investigate the influence of bypass with sequential bypass effects in the stenosed coronary artery. Numerical analyses are focused on the understanding of the flow patterns for different sequential anastomosis techniques. Blood flow field is treated as two-dimensional incompressible laminar flow. The finite volume method is adopted for discretization of the governing equations. The Carreau model is employed as the constitutive equation for blood. To find the optimal sequential bypass anastomotic configurations, the mass flow rates at the outlet of different models are compared quantitatively.

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Dosimetry and Medical Internal Radiation Dose of Re-188-DTPA for Endovascular Balloon Brachytherapy Against Restenosis after Coronary Angioplasty (혈관성형술 후 재협착 방지 치료에 사용하기 위한 원통형 풍선 Re-188-DTPA의 선량 분포와 내부피폭 선량)

  • Lee, Jin;Lee, Dong-Soo;Shin, Seung-Ae;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.163-171
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    • 1999
  • Purpose: Liquid beta emitter filled in angioplasty balloon could be used to perform endovascular balloon brachytherapy to prevent coronary artery restenosis. We investigated the dosimetry for Re-188-DTPA liquid-filled balloon and medical internal radiation dosimetry in case of balloon leakage. Materials and Methods: We estimated radiation dose from an angioplasty balloon (20 mm length, 3 mm diameter cylinder) to the adjacent vessel wall using Monte Carlo EGS4 code. We obtained time-activity curves of kidneys in normal dog and calculated $T_{max},\;T_{1/2}$. Using MIRDOSE3 program, we estimated absorbed doses to the major organs (kidneys, bladder) and the whole body when we assumed that balloon leaked all the isotope contained. Results: The radiation dose was 17.5 Gy at the balloon surface when we applied 3,700 MBq/ml of Re-188 for 100 seconds, Fifty percent of the energy deposited within 1 mm from the balloon surface. The estimated internal dose to the whole body was 0.005 mGy/MBq and 18.5 mGy for the spillage of 3,700 MBq of Re-188. Conclusion: We suggest that Re-188-DTPA can be used for endovascular balloon brachytherapy to inhibit coronary artery restenosis after angioplasty with tolerable whole body radiation dose in case of balloon rupture.

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