Browse
Submit Data
Databases
API
Help

Dataset Information

25 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Peri-Contrast Staining as a Marker of Stent Failure: Restenosis, Thrombosis, and Fracture

ABSTRACT: Peri-stent contrast staining (PSS), defined as contrast staining around the stent struts, has been identified as an indicator of future stent failure in first generation, sirolimus-eluting coronary stents. 1 PSS has been associated with in-stent restenosis, stent thrombosis, stent fracture, and the development of coronary aneurysm. As the frequency of patients with first generation sirolimus-eluting coronary stents becomes infrequent; PSS may go unrecognized. Herein, we present a patient with a decade of longitudinal follow-up, who developed PSS identified on coronary angiogram with recurrent stent failure.

SUBMITTER: Mshelbwala F

PROVIDER: S-EPMC8556128 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Late peri-stent contrast staining appearance due to rupture of atherogenic neointima following drug-eluting stent.

Project description:The development of peri-stent contrast staining (PSS) after coronary intervention with implantation of a stent is observed in approximately 1-3% of patients treated with drug-eluting stent. Although the cumulative incidences of late in-stent restenosis and stent thrombosis are significantly higher in lesions with PSS than in those without the finding, the mechanisms for the development of PSS have not yet been fully elucidated. In this report, we describe a case of rapid development of PSS with ulcer formation caused by rupture of atherogenic neointima, which was observed by serial optical coherence tomography examinations over 6 months. Protrusion of the stent-jailed underlying necrotic core toward the lumen by the contracting force might have resulted in formation of atherogenic neointima within the stent. Subsequently, rupture of this necrotic core induced by iatrogenic neointimal injury due to balloon dilation and dissolution of the accumulated necrotic core may have resulted in PSS formation 6 months after the procedure. These findings may be helpful for consideration of etiology and therapeutic strategy for lesions with PSS. <Learning objective: The mechanisms of peri-stent contrast staining (PSS) formation late after drug-eluting stent (DES) implantation are diverse. Rupture of atherogenic neointima with subsequent dissolution of the stent-jailed underlying plaque debris could be one of the mechanisms of rapid PSS formation after implantation of DES. An accurate assessment of lesion morphology within the stent and patient-tailored management can reduce morbidity and mortality in patients who have undergone DES implantation.>.

| S-EPMC8103349 | biostudies-literature

Two peri-stent contrast stainings and one late restenosis in the late phase after sirolimus-eluting stent implantation.

Project description:Both peri-stent contrast staining (PSS) and late restenosis are abnormal findings after drug-eluting stent implantation and they occur with low incidence. We describe a case with two PSSs and one late restenosis after sirolimus-eluting stent implantation. Persistent high value of C-reactive protein in this patient suggested chronic systematic inflammation as a contributing factor of these abnormal findings. <Learning objective: The advent of drug-eluting stents has dramatically reduced in-stent restenosis. However, there are still some concerns about long-term safety. We show a case with multiple sirolimus-eluting stent-related complications, taking into account the underlying pathogenesis.>.

| S-EPMC6281823 | biostudies-other

Failure of drug-coated balloon angioplasty to treat bare metal in-stent restenosis accompanied by late stent thrombosis but successful treatment of binary in-stent restenosis.

Project description:Drug-coated balloons (DCB) are effective in treating in-stent restenosis (ISR) with neointimal proliferation after bare-metal stent (BMS) implantation, but it is unclear whether DCB are effective in treating BMS-ISR accompanied by thrombosis. An 84-year-old man with previous inferior myocardial infarction and atrial fibrillation developed acute myocardial infarction (AMI) during hospitalization for intracerebral hemorrhage. Emergent coronary angiography (CAG) revealed severe stenosis of the distal left circumflex coronary artery. We implanted a BMS to avoid long-term triple antithrombotic therapy. He received aspirin, clopidogrel, and rivaroxaban for 1 month and then received clopidogrel and rivaroxaban. Seventy days after BMS implantation, he developed AMI, and emergent CAG revealed occlusion of the BMS due to late stent thrombosis. After thrombus aspiration, intravascular ultrasound showed incomplete neointimal healing in the proximal portion of the stent and excessive neointimal proliferation in the distal portion of the stent. DCB angioplasty of the entire BMS was performed after scoring balloon pre-dilation. Seven months after BMS implantation, follow-up CAG revealed binary ISR. DCB angioplasty of the entire BMS was performed again after scoring balloon pre-dilation. Thirteen months after BMS implantation, follow-up CAG did not reveal recurrence of ISR. <Learning objective: Drug-coated balloons (DCB) were ineffective when there was excessive neointimal proliferation accompanied by thrombosis, but effective in binary in-stent restenosis (ISR). DCB may be ineffective in early ISR after bare-metal stent implantations and when there is excessive neointimal proliferation accompanied by thrombosis. Since the safety and efficacy of DCB to treat excessive neointimal proliferation occurring with late stent thrombosis is unclear, further studies are needed.>.

| S-EPMC6718827 | biostudies-other

Intravascular Imaging for Guiding In-Stent Restenosis and Stent Thrombosis Therapy.

Project description:Advances in stent technology and the design of endovascular devices with thinner struts, anti-inflammatory and antithrombotic polymers, and better drug kinetics have enhanced the safety and efficacy of the second-generation drug-eluting stents and broadened their use in the therapy of high-risk patients and complex anatomies. However, despite these developments, in-stent restenosis and stent thrombosis remain the Achilles' heel of percutaneous coronary intervention, with their cumulative incidence reaching up to 10% at 5 years following percutaneous coronary intervention. The treatment of stent failure poses challenges and is associated with a worse prognosis than conventional percutaneous coronary intervention. Several studies have recently highlighted the value of intravascular imaging in identifying causes of stent failure, underscored its role in treatment planning, and registries have shown that its use may be associated with better clinical outcomes. The present review aims to summarize the evidence in the field; it discusses the value of intravascular imaging in identifying the mechanisms of in-stent restenosis and stent thrombosis in assessing the morphological characteristics of neointima tissue that appears to determine long-term outcomes in evaluating procedural results, and presents the findings of studies supporting its value in guiding therapy in stent failure.

| S-EPMC9750080 | biostudies-literature

SCAI Expert Consensus Statement on Management of In-Stent Restenosis and Stent Thrombosis

Project description: Not available

| S-EPMC11308135 | biostudies-literature

Histopathologically confirmed very late stent thrombosis associated with stent fracture after implantation of first-generation drug eluting stent.

Project description: Not available

| S-EPMC8016029 | biostudies-literature

Pseudo-aneurysm caused by stent fracture in the "sub-acute" phase after endovascular therapy for in-stent restenosis lesions.

Project description:Despite the reported favorable patency of stents in the treatment of femoropopliteal lesions, concern regarding stent fracture is increasing. Development of pseudo-aneurysm by stent fracture is rare and has been reported to occur in the chronic phase owing to mechanical fatigue. Here, we present the first report of a pseudo-aneurysm caused by stent fracture in the "sub-acute" phase after endovascular therapy for in-stent restenosis lesion. A 79-year-old man underwent endovascular therapy for an in-stent restenosis lesion of the right superficial femoral artery. Echography 48 days after the treatment showed a saccular pseudo-aneurysm at the proximal stent site, suggestive of stent fracture. Angiography confirmed the pseudo-aneurysm caused by stent fracture. A self-expandable endoluminal stent graft was deployed, which showed complete resolution of the pseudo-aneurysm. A pseudo-aneurysm caused by stent fracture can occur in the "sub-acute" phase after endovascular therapy for in-stent restenosis lesions. <Learning objective: Although rare, a pseudo-aneurysm owing to stent fracture can occur in the "sub-acute" phase after endovascular therapy for in-stent restenosis lesions.>.

| S-EPMC7326663 | biostudies-literature

Development of gene expression signatures for In-stent Restenosis

Project description:To further development of our gene expression approach to Restenosis, we have employed lncRNA microarray expression profiling.

2021-09-04 | GSE182225 | GEO

Zero contrast optical coherence tomography-guided percutaneous coronary intervention for in-stent restenosis of the saphenous vein graft using a non-contrast flush medium.

Project description:Percutaneous coronary intervention (PCI) is often denied for individuals with coronary artery disease who are prone to develop contrast-induced acute kidney injury. We report a 73-year-old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with in-stent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guided-PCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the flush medium. Our report suggests the safety and feasibility of LMWD-40-based OCT-guided zero contrast PCI in ISR of SVG in a CKD patient, although further prospective studies are needed to evaluate this technique.

| S-EPMC6309879 | biostudies-literature

Coronary stent fracture.

Project description: Not available

| S-EPMC3153548 | biostudies-literature