Maciej Pruski

Comparable clinical safety and efficacy of biodegradable versus durable polymer paclitaxel eluting stents despite shorter dual antiplatelet therapy: Insights from a multicenter, propensity score‐matched registry

The biodegradable polymer drug‐eluting stents have been proposed as an alternative to durable polymer DES, theoretically improving vessel healing and reducing the need for prolonged double anti platelet therapy (DAPT), however clinical significance of this technology is under debate. Therefore, we sought to compare the clinical outcomes of two Paclitaxel eluting stents (PES) containing different polymer‐based eluting matrices.

MynxGrip for Closure of Antegrade Puncture After Peripheral Interventions With Same-Day Discharge

Background: This was the first prospective study to assess the safety and efficiency of MynxGrip vascular closure device (VCD) in peripheral interventions with antegrade access. Methods and Results: We enrolled 66 consecutive patients from 1 center. All patients were discharged home on the day of procedure and were observed for adverse events at 1 and 30 days of follow-up. No major complications were observed. The rate of minor complications (conversion to manual or mechanical compression) was 7.6%. Postdischarge, 3% of patients experienced minor complications—small abscess, ipsilateral deep vein thrombosis. In 1 patient, a second VCD was deployed after device failure. The derived device failure rate was 5.9%. No patients required hospitalization. No late bleeding and no hematomas >6 cm were noted. The mean time to discharge was 4 hours and 5 minutes. Conclusion: The MynxGrip was safe and effective in sealing access sites after antegrade femoral artery puncture with same-day discharge.

Long-Term Outcomes After Percutaneous Lower Extremity Arterial Interventions With Atherectomy vs. Balloon Angioplasty ― Propensity Score-Matched Registry ―

BACKGROUND The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization.Methods and Results:This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization. PTA was performed in 215 patients, and AT in 204 (Silver Hawk, EV3, n=125; CSI 360°, n=66; Pathway Medical Technologies, n=13). There were no significant between-group differences in baseline characteristics except for increased CAD, dialysis and CLI prevalence in the PTA group. Following propensity score analysis 131 well-matched pairs were included in analysis. Bail-out stenting was more frequent in the reference group (PTA, 6.1% vs. AT, 0%; P=0.004). At 6- and 12-month follow-up there were no differences in TLR between the groups (PTA, 8.3% vs. AT, 5.3%; P=0.47; and PTA, 16.7% vs. AT, 13.7%; P=0.73, respectively). The difference was in favor of AT at 24-month follow-up (PTA, 29.0% vs. AT, 16.7%; P=0.05). No difference was observed in amputation rate (PTA, 0.7% vs AT, 1.5%; P=0.62). On Kaplan-Meier analysis there were no significant differences between groups in time to TLR, amputation or death. CONCLUSIONS AT was associated with lower risk of TLR, and this should be confirmed in randomized controlled trials.

Comparable vascular response of a new generation sirolimus eluting stents when compared to fluoropolymer everolimus eluting stents in the porcine coronary restenosis model

BACKGROUND Novel sirolimus eluting stents (SES) have shown non-inferior clinical outcomes when compared to everolimus eluting stents (EES), however only limited preclinical data have been published. Therefore, we evaluate vascular response of a new generation biodegradable polymer SES (BP-SES: Alex Plus, Balton) and fluoropolymer EES (EES: Xience Pro, Abbott) in the porcine coronary restenosis model. METHODS A total of 40 stents were implanted with 120% overstretch in coronaries of 17 domestic swine: 16 BP-SES, 16 EES and 8 bare metal controls (BMS). Following 28 and 90 days, coronary angiography and optical coherence tomography (OCT) was performed, animals sacrificed and stented segments harvested for pathological evaluation. RESULTS At 28 days neointimal thickness in OCT was lowest in the BP-SES when compared to EES and BMS (0.18 ± 0.1 vs. 0.39 ± 0.1 vs. 0.34 ± 0.2 mm, respectively; p = 0.04). There was no difference in the proportion of malapposed or uncovered struts, although protruding covered struts were more common in BP-SES (14.8 ± 10% vs. 4.1 ± 4% vs. 3.7 ± 6%; p = 0.03). In pathology, the lowest neointimal thickness was confirmed in BP-SES (p < 0.05). The inflammation score was significantly lower in BP-SES and EES when compared to BMS (0.24 ± 0.1 vs. 0.4 ± 0.1 vs. 0.77 ± 0.4; p < 0.01) whilst EES and BP-SES had higher fibrin scores than BMS (1.2 ± 0.4 vs. 1.3 ± 0.3 vs. 0.17 ± 0.2; p < 0.01). At 90 days neointimal coverage and thickness in OCT was comparable between groups and healing in histopathology was complete. CONCLUSIONS New generation, BP-SES show similar vascular healing and biocompatibility profile with marginally higher degree of restenosis inhibition, when compared to fluoropolymer EES in the porcine coronary restenosis model.

Safety and feasibility of same-day early discharge after endovascular revascularization of lower extremities in elderly. SENIOR-ER registry

The aim of the study was to assess safety and feasibility of one‐day early discharge (ODD) after endovascular revascularization (ER) of lower extremities in elderly.

TCT-803 Long term outcomes in diabetic patients treated with atherectomy for peripheral artery disease

The diabetic patients are more hazarded for the restenosis after revascularization of arteries of lower extremities. The long term outcome after atherectomy revascularization in diabetic patients in not known. The aim of this study is to compare outcomes of atherectomy treatment in diabetic (DM) vs

TCT-71 The NIREUS Randomized Trial: 1-Year Results of the BioNIR Ridaforolimus-Eluting Coronary Stent System (BioNIR) EUropean Angiography Study

The BioNIR stent (Medinol, Israel) is a thin strut (91 um) cobalt chromium drug-eluting stent, which uses the rapamycin analogue ridaforolimus and a novel durable elastomeric polymeric coating (CarboSil® 20 55D). The NIREUS trial compared BioNIR with the Resolute (Medtronic, USA) zotarolimus-

TCT-837 Comparable vascular response of a new generation sirolimus eluting stents when compared to fluoropolymer everolimus eluting stents in the porcine coronary restenosis model.

TCT-836 Endothelial Cell Coverage and Inflammation Comparing COBRA Polyzene-F (PzF) Coated Stent to Durable Fluoropolymer and Biodegradable Polymer Drug-Eluting Stents in a Rabbit Model Kazuyuki Yahagi, Frank Kolodgie, Daivid Cheng, Eduardo Acampado, Hiroyoshi Mori, Khaja Chinnakondepali, Maria Romero, Aloke Finn, Renu Virmani CVPath Institute, Inc., Geithersburg, Maryland, United States; CVPath Institute, Gaithersburg, Maryland, United States; Unknown, Bethesda, Maryland, United States; University Hospital La Timone; Division of cardiovascular surgery, Saiseikai Kumamoto Hospital Cardiovascular center; St. Luke’s Mid America Institute; Duke Clinical Research Institute; CVPath Institute Inc. and University of Maryland, Baltimore, Gaithersburg, Maryland, United States; CVPath Institute, Inc., Gaithersburg, Maryland, United States

TCT-348 Long term outcomes of same-day discharged patient after percutaneous coronary intervention in stand-alone centers

TCT-347 Independent Predictors of Mace at Different Time Points After the Treatment of Non-Selected Patients With Drug-Eluting Stents: An Analysis of the Desire Registry Jose Costa, Jr., Amanda Sousa, Adriana Moreira, Ricardo Costa, Galo Maldonado, Manuel Cano, J. Eduardo Sousa Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil; Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil; Hospital do Coracao, São Paulo, São Paulo, Brazil; Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil; Hospital Beneficencia Portuguesa, São Paulo, São Paulo, Brazil; Hospital do Coração, São Paulo, São Paulo, Brazil; Uknown, Sao Paulo, São Paulo, Brazil