Coronary Stenting

This book focuses on the coronary bioresorbable scaffold, a new interventional treatment for coronary artery disease, differentiated from a permanent metallic stent. The book provides an overview of the technology including non-clinical studies and clinical evidences in order to help clinicians understand the appropriate application of the technology and the optimal techniques of implantation. It covers the basics of bioresorbable scaffolds; bench test results; preclinical studies; clinical evidences; and tips and tricks of implantation.

This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.

The sucess of coronary artery stenting is the result of improved implantation techniques, a much better understanding of the vascular response to injury, and advances in the adjunctive pharmacology. Industry has also contributed greatly by providing more versatile and user friendly stents, designed specifically to address the probelms of thrombosis and restenosis, as well as particular lesions types and clinical situations. This text covers the latest available stents, clinical trials, indications for stenting and cost considerations.

This book provides a comprehensive, up-to-date summary of drug-coated balloon (DCB) technology and the role of DCBs in the treatment of coronary and peripheral arterial disease. In addition to clear explanation of how DCBs works, readers will find an enlightening analysis of the mistakes and successes of the past decade and the emergence of the latest delivery systems, which combine a more deliverable device with much improved drug delivery to the vessel wall. The full range of current applications of DCBs are reviewed in detail, drawing on the latest scientific evidence. Due attention is paid to newer devices, with provision of technical insights and documentation of the available clinical data. Ongoing research projects, remaining technical challenges, likely future directions, and reimbursement issues are also carefully considered. This book will be a useful tool for any interventional cardiologist, interventional radiologist, or vascular surgeon who wishes to acquire a deep knowledge of this technology and its application in both coronary and peripheral interventions.

Over the past 15 years, a multitude of new transluminal techniques have been developed, all designed to broaden the range of indications and improve the results of angioplasty. Among these, the implantation of intravascular stents has emerged as the technique with the greatest promise. It has become clear that stenting not only successfully deals with the problem of abrupt closure after angioplasty, but also reduces the incidence of restenosis, the Achilles heel of angioplasty. The reason why restenosis is reduced may be because the immediate gain of luminal diameter is greater with stenting than with any other technique. Even if the late loss of diameter is similar among most currently used transluminal techniques, the end result will stilI be better after stenting because of the nearly ideal primary effect. The aims of this book are twofold: first it presents a state-of-the-art summary of the progress made in stenting so far, and secondly it details some of the prospects for future improvement. The concept of stenting has proved to be a correct one, and therefore alI future efforts wilI be directed towards new, safe, and biologicalIy "friendly" stents.

Make optimal use of the latest coronary stenting techniques and adjunctive devices with well-rounded guidance from Coronary Stenting, a companion volume to Dr. Topol’s Textbook of Interventional Cardiology. This comprehensive, up-to-date interventional cardiology book keeps you abreast of the latest trial data on efficacy and safety as well as cutting-edge clinical applications in coronary stenting. Achieve optimal outcomes and minimize complications with expert guidance from the foremost teachers and writers in the field of interventional cardiology. Implement the latest knowledge on cutting-edge topics such as drug-eluting stent design; appropriate interpretation of randomized clinical trials and comparative effectiveness studies of coronary stents; the use of fractional flow reserve, intravascular ultrasound and optical coherence tomography to optimize lesion selection and stent implantation; anterograde and retrograde approaches to chronic total occlusions; and percutaneous revascularization of diabetics and patients with left main or multivessel disease. Quickly and easily find the coronary stenting information you need thanks to highly templated chapters and high-quality full-color illustrations that incorporate the latest clinical trial data into recommendations for proper patient and device selection.

Surgeons refer to this classic text again and again, partly because of the clarity of its innovative format, so useful and popular that it has been copied by others. This technical manual, now in its fourth edition, profiles all of the commercially available stents and some of those in early registry. The technical specifications of the stent and delivery systems are tabulated; each stent is illustrated in its unexpanded, mounted and expanded form (depending on the type of stent). Angiograms show the stent in situ. Handbook of Coronary Stents is a necessary adjunct for all those involved in interventional cardiology.

In June 1989, a third conference concentrating on the progress in quantita tive coronary angiography and related techniques was held in Rotterdam, again very successful as the two preceding events in 1985 and 1987. Tech nical as well as clinical aspects of digital and digitized coronarography, morphometry, parametric imaging and functional quantification of the human coronary circulation were presented and discussed by prominent exponents of those groups who have been active in this particular field for many years. This book contains the chapters representing the lectures held by leading experts during the symposium that update the knowledge currently available, including most recent aspects in angioscopy and intravascular ultrasound imaging. It also includes a historical review on the development of angiogra phic techniques from the very early days on to our times given by one of the pioneers in heart catheterization and angiography, Dr. Kurt Amplatz. Those who had the chance to listen to his talk, will surely remember his impressive, humorous lecture as one of the highlights of this meeting.

Chronic total occlusions (CTO) are common, and found in approximately one third of patients with significant coronary artery disease who undergo angiography. Over the past 20 years, CTO lesions have represented the most difficult anatomy for treatment — with lower success rates and higher complication rates. Chronic Total Occlusions provides interventionalists insight into the world of CTOs with introductory chapters that describe the pathology and indications of CTOs along with a review of clinical trials. Imaging modalities including CT angiography, magnetic navigation wire, and IVUS guided recanalization of CTO are also introduced, together with information on new wires technology and devices for CTOs. With numerous illustrations of these devices, technologies, and strategies to improve the CTO success rate, this clinical guide, headed up by Ron Waksman, will prove to be the ideal companion for interventional cardiologists and cardiac surgeons who are required to perform angioplasty and coronary stenting.