The Experts below are selected from a list of 3237 Experts worldwide ranked by ideXlab platform
Michael H Wholey - One of the best experts on this subject based on the ideXlab platform.
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Use of AngioJet mechanical thrombectomy for acute peripheral ischemia associated with Stent Fracture.
Catheterization and Cardiovascular Interventions, 2007Co-Authors: Joel E. Barbato, Michael H WholeyAbstract:Stent Fracture has been an uncommonly described etiology in the development of acute peripheral ischemia. We describe the utilization of a rheolytic thrombectomy catheter with thrombolytics for the rapid treatment of superficial femoral artery thrombosis after recanalization and subsequent Stent Fracture. The implications of Stent Fracture and the therapeutic maneuvers associated with their treatment in peripheral applications are discussed. © 2007 Wiley-Liss, Inc.
Takashi Kubo - One of the best experts on this subject based on the ideXlab platform.
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serial angiographic findings and prognosis of Stent Fracture site without early restenosis after sirolimus eluting Stent implantation
American Heart Journal, 2010Co-Authors: Yasushi Ino, Takashi Kubo, Yasuaki Toyoda, Atsushi Tanaka, Shuuta Ishii, Yoshio Kusuyama, Shigeho Takarada, Hironori Kitabata, Takashi Tanimoto, Kumiko HirataAbstract:Background Stent Fracture is one of the possible causes of in-Stent restenosis after sirolimus-eluting Stent (SES) implantation. However, long-term prognosis including late restenosis in Stent Fracture site without early restenosis remains unknown. The aim of this study is to investigate the risk of late restenosis at the Stent Fracture site without early restenosis after SES implantation. Methods We divided 366 patients with 490 lesions into 2 groups with or without Stent Fracture based on the first scheduled follow-up coronary angiography (Fracture group, 21 lesions; nonFracture group, 469 lesions). The second scheduled follow-up coronary angiography (>15 months after SES implantation) was performed in 83 patients with 124 lesions. Results Target lesion revascularization due to late restenosis at the Stent Fracture site did not occur in the Fracture group, but occurred in 5 lesions in the nonFracture group. At the first follow-up, minimal luminal diameter was significantly smaller and percentage diameter stenosis was significantly larger in the Fracture group (1.98 ± 0.41 vs 2.52 ± 0.49 mm, P = .001 and 30.5% ± 13.1% vs 13.0% ± 8.8%, P P = .01 and P = .007, respectively). In each group, there were no significant changes in minimal luminal diameter, percentage diameter stenosis, and late lumen loss between the first and second follow-up. Conclusions Late restenosis was not observed in Stent Fracture sites without early restenosis during the midterm follow-up after SES implantation.
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predictors and prognosis of Stent Fracture after sirolimus eluting Stent implantation
Circulation, 2009Co-Authors: Yasushi Ino, Takashi Kubo, Yasuaki Toyoda, Atsushi Tanaka, Shuuta Ishii, Yoshio Kusuyama, Shigeho Takarada, Hironori Kitabata, Takashi Tanimoto, Masato MizukoshiAbstract:Background: Stent Fracture is a cause of in-Stent restenosis (ISR) after sirolimus-eluting Stent (SES) implantation, so this study investigated the incidence, predictors and prognosis of Stent Fracture. Methods and Results: The 273 consecutive patients (364 lesions) after SES implantation and who had 6-9 month' scheduled follow-up coronary angiography (CAG) were divided into groups with and without Stent Fracture. Δangle was defined as the difference in the angle in the target lesion between diastole and systole before the procedure. The incidence of Stent Fracture was 4.9% (18 of 364 lesions). Δangle in the target lesion was larger in the Fracture group (28.3 ±11.5° vs 12.3 ±9.0°, P<0.0001). Independent predictors of Stent Fracture were Δangle and total Stent length. The rates of binary restenosis and target lesion revascularization (TLR) were higher in the Fracture group (33% vs 4.0%, P=0.0002 and 28% vs 3.5%, P=0.0007, respectively). There were no major adverse cardiac events (MACE) in the Fracture group during a mean 24-month follow-up after follow-up CAG. Conclusions: Predictors of Stent Fracture were Δangle and total Stent length. Although Stent Fracture was associated with ISR and TLR, it was not associated with MACE during long-term follow-up. (Circ J 2009; 73: 2036-2041)
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Predictors and prognosis of Stent Fracture after sirolimus-eluting Stent implantation.
Circulation journal : official journal of the Japanese Circulation Society, 2009Co-Authors: Yasushi Ino, Takashi Kubo, Yasuaki Toyoda, Atsushi Tanaka, Shuuta Ishii, Yoshio Kusuyama, Shigeho Takarada, Hironori Kitabata, Takashi Tanimoto, Masato MizukoshiAbstract:Background: Stent Fracture is a cause of in-Stent restenosis (ISR) after sirolimus-eluting Stent (SES) implantation, so this study investigated the incidence, predictors and prognosis of Stent Fracture. Methods and Results: The 273 consecutive patients (364 lesions) after SES implantation and who had 6-9 month' scheduled follow-up coronary angiography (CAG) were divided into groups with and without Stent Fracture. Δangle was defined as the difference in the angle in the target lesion between diastole and systole before the procedure. The incidence of Stent Fracture was 4.9% (18 of 364 lesions). Δangle in the target lesion was larger in the Fracture group (28.3 ±11.5° vs 12.3 ±9.0°, P
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Classification and potential mechanisms of intravascular ultrasound patterns of Stent Fracture.
The American journal of cardiology, 2009Co-Authors: Hiroshi Doi, Akiko Maehara, Gary S. Mintz, Kenichi Tsujita, Takashi Kubo, Celia Castellanos, Jian Liu, Junqing Yang, Carlos Oviedo, Jiro AokiAbstract:We sought to examine the intravascular ultrasound (IVUS) findings of Stent Fracture. Stent Fracture has been implicated as a cause of drug-eluting Stent failure. IVUS is more likely to identify mechanisms of Stent failure -- including Stent Fracture -- than angiography. Twenty Stent Fractures diagnosed by IVUS in 17 patients were evaluated. Eighteen Stent Fractures (90%) occurred in sirolimus-eluting Cypher Stents, and 2 Stent Fractures (10%) occurred in bare metal Stents, but none occurred in paclitaxel-eluting Taxus Stents. Half of the Stent Fractures presented 1 year after implantation. IVUS analysis showed that 9 Stent Fractures were complete (45%) and 11 were partial (55%); 10 (50%) were adjacent to Stent metal overlap; and 5 occurred in a coronary aneurysm accompanied by malapposition (all Cypher Stents) despite the absence of an aneurysm at index Stenting. Compared with 60 matched control segments in patients without Stent Fracture, but with similar clinical events, the Stent Fracture group had longer Stent segments (45.2 +/- 23.0 vs 28.5 +/- 14.9 mm, p = 0.003). Comparing Stent Fractures associated with an aneurysm (n = 5) with those that did not occur in association with an aneurysm (n = 15) showed that complete Stent Fracture was more frequent (100% vs 27%, p = 0.008), and all presented >1 year after index Stenting (vs 33%, p = 0.03). In conclusion, IVUS is helpful to identify Stent Fracture as a cause of Stent failure and to understand possible mechanisms of Stent Fracture such as aneurysm formation.
Jiro Aoki - One of the best experts on this subject based on the ideXlab platform.
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Classification and potential mechanisms of intravascular ultrasound patterns of Stent Fracture.
The American journal of cardiology, 2009Co-Authors: Hiroshi Doi, Akiko Maehara, Gary S. Mintz, Kenichi Tsujita, Takashi Kubo, Celia Castellanos, Jian Liu, Junqing Yang, Carlos Oviedo, Jiro AokiAbstract:We sought to examine the intravascular ultrasound (IVUS) findings of Stent Fracture. Stent Fracture has been implicated as a cause of drug-eluting Stent failure. IVUS is more likely to identify mechanisms of Stent failure -- including Stent Fracture -- than angiography. Twenty Stent Fractures diagnosed by IVUS in 17 patients were evaluated. Eighteen Stent Fractures (90%) occurred in sirolimus-eluting Cypher Stents, and 2 Stent Fractures (10%) occurred in bare metal Stents, but none occurred in paclitaxel-eluting Taxus Stents. Half of the Stent Fractures presented 1 year after implantation. IVUS analysis showed that 9 Stent Fractures were complete (45%) and 11 were partial (55%); 10 (50%) were adjacent to Stent metal overlap; and 5 occurred in a coronary aneurysm accompanied by malapposition (all Cypher Stents) despite the absence of an aneurysm at index Stenting. Compared with 60 matched control segments in patients without Stent Fracture, but with similar clinical events, the Stent Fracture group had longer Stent segments (45.2 +/- 23.0 vs 28.5 +/- 14.9 mm, p = 0.003). Comparing Stent Fractures associated with an aneurysm (n = 5) with those that did not occur in association with an aneurysm (n = 15) showed that complete Stent Fracture was more frequent (100% vs 27%, p = 0.008), and all presented >1 year after index Stenting (vs 33%, p = 0.03). In conclusion, IVUS is helpful to identify Stent Fracture as a cause of Stent failure and to understand possible mechanisms of Stent Fracture such as aneurysm formation.
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incidence and clinical impact of coronary Stent Fracture after sirolimus eluting Stent implantation
Catheterization and Cardiovascular Interventions, 2007Co-Authors: Jiro Aoki, Gaku Nakazawa, Kengo Tanabe, Angela Hoye, Hirosada Yamamoto, Tomohiro Nakayama, Yoshinobu Onuma, Yasutomi Higashikuni, Syuji Otsuki, Atsuhiko YagishitaAbstract:Background: Stent Fracture is one of the possible causes of restenosis after sirolimus-eluting Stents (SES) implantation. The aim of our study was to evaluate the prevalence and clinical impact of coronary Stent Fracture after SES implantation. Methods: From our prospective institutional database, 280 patients were treated solely with SES from August 2004 to June 2005. Among the 280 patients, 256 patients with a total of 307 lesions underwent follow-up angiography on an average of 240 days after the procedure. Results: Stent Fractures were observed in eight (2.6%) lesions. Of the eight lesions with Stent Fracture, five were located in the right coronary artery (RCA), two in the saphenous vein (SV) graft, and one in the left anterior descending coronary artery. The Stent Fractures were all in the locations that served as hinges during vessel movement in the cardiac contraction cycle. Seven of the eight Stent Fractures were adjacent to the edge of previously implanted or overlapped Stent. Significant multivariate predictors of Stent Fracture were SV graft location (Odds ratio 35.88; 95% confidence interval 2.73–471.6, P = 0.006), implanted Stent length (Odds ratio 1.04; 95% confidence interval 1.01–1.07, P = 0.02), and RCA location (Odds ratio 10.00; 95% confidence interval 1.11–89.67, P = 0.04). In-Stent binary restenosis rate was 37.5% and target lesion repeat revascularization rate was 50.0% in patients with Stent Fracture. Conclusions: Stent Fracture was likely to be affected by mechanical stress provoked by rigid structures and hinge points. Stent Fracture might be associated with the high incidence of target lesion revascularization. © 2006 Wiley-Liss, Inc.
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Incidence and clinical impact of coronary Stent Fracture after sirolimus‐eluting Stent implantation
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2007Co-Authors: Jiro Aoki, Gaku Nakazawa, Kengo Tanabe, Angela Hoye, Hirosada Yamamoto, Tomohiro Nakayama, Yoshinobu Onuma, Yasutomi Higashikuni, Syuji Otsuki, Atsuhiko YagishitaAbstract:Background: Stent Fracture is one of the possible causes of restenosis after sirolimus-eluting Stents (SES) implantation. The aim of our study was to evaluate the prevalence and clinical impact of coronary Stent Fracture after SES implantation. Methods: From our prospective institutional database, 280 patients were treated solely with SES from August 2004 to June 2005. Among the 280 patients, 256 patients with a total of 307 lesions underwent follow-up angiography on an average of 240 days after the procedure. Results: Stent Fractures were observed in eight (2.6%) lesions. Of the eight lesions with Stent Fracture, five were located in the right coronary artery (RCA), two in the saphenous vein (SV) graft, and one in the left anterior descending coronary artery. The Stent Fractures were all in the locations that served as hinges during vessel movement in the cardiac contraction cycle. Seven of the eight Stent Fractures were adjacent to the edge of previously implanted or overlapped Stent. Significant multivariate predictors of Stent Fracture were SV graft location (Odds ratio 35.88; 95% confidence interval 2.73–471.6, P = 0.006), implanted Stent length (Odds ratio 1.04; 95% confidence interval 1.01–1.07, P = 0.02), and RCA location (Odds ratio 10.00; 95% confidence interval 1.11–89.67, P = 0.04). In-Stent binary restenosis rate was 37.5% and target lesion repeat revascularization rate was 50.0% in patients with Stent Fracture. Conclusions: Stent Fracture was likely to be affected by mechanical stress provoked by rigid structures and hinge points. Stent Fracture might be associated with the high incidence of target lesion revascularization. © 2006 Wiley-Liss, Inc.
Osamu Iida - One of the best experts on this subject based on the ideXlab platform.
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Popliteal Pseudoaneurysm Caused by Stent Fracture
Annals of vascular surgery, 2011Co-Authors: Yoshihiko Tsuji, Osamu Iida, Ikuro Kitano, Satoru Kajita, Katsuhiro Sawada, Shinsuke NantoAbstract:Stent Fracture with pseudoaneurysm formation in the femoropopliteal artery has uncommonly been reported. We present the case of a 72-year-old man with a Fracture of self-expanding nitinol Stent and a pseudoaneurysm formation in the suprageniculate popliteal artery. The popliteal artery was successfully reconstructed with a small saphenous vein graft interposition.
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Influence of Stent Fracture on the Long-Term Patency in the Femoro-Popliteal Artery: Experience of 4 Years
JACC. Cardiovascular interventions, 2009Co-Authors: Osamu Iida, Shinsuke Nanto, Masaaki Uematsu, Kuniyasu Ikeoka, Shin Okamoto, Seiki NagataAbstract:Objectives We investigated the time course of Stent patency in the femoro-popliteal artery for as long as 4 years. Background Stent Fracture has been related to poor 2-year patency in the femoro-popliteal artery. Methods We studied 239 consecutive patients who underwent provisional de novo Stenting with nitinol Stents for 333 limbs (Luminexx Stent [C. R. Bard, Inc., Murray Hill, New Jersey] in 91 limbs; Smart Stent [Cordis Corp., Miami Lakes, Florida] in 242 limbs) from April 2004 to December 2007. Stent Fracture was determined by X-ray with multiple projections. Patency was assessed by duplex ultrasonography as peak systolic velocity ratio Results Primary patency was 81%, 74%, 68%, and 65% at 1, 2, 3, and 4 years, respectively. Stent Fracture occurred in 14% (78 of 544) per Stent and 17% (55 of 333) per limbs. Stent Fracture was significantly associated with multiple Stent deployments (with Fracture = 2.3 ± 0.9 Stents vs. without Fracture = 1.5 ± 0.7 Stents, p Conclusions Stent Fracture worsened the patency during the first 2 years, but it did not apparently affect patency beyond 2 years. In particular, complete Stent separation did not affect patency.
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effect of exercise on frequency of Stent Fracture in the superficial femoral artery
American Journal of Cardiology, 2006Co-Authors: Osamu Iida, Shinsuke Nanto, Masaaki Uematsu, Takakazu Morozumi, Junichi Kotani, Masaki Awata, Toshinari Onishi, Fusako Sera, Hitoshi Minamiguchi, Hirokuni AkahoriAbstract:Stent Fracture has emerged as a new problem in the percutaneous transluminal angioplasty of the superficial femoral artery (SFA). The aim of our study was to delineate the factors influencing nitinol Stent Fracture in the SFA. Forty consecutive patients with peripheral artery disease who underwent rescue Stenting with a nitinol Stent (Luminexx, Bard) in the SFA were enrolled between May 2004 and January 2005. Follow-up angiography was performed 13.6 ± 1.0 months later to detect Stent Fracture. Stent Fracture occurred in 11 patients (28%). Lesion length >100 mm, the number of Stents used, the lesion involving the distal SFA, chronic total occlusion, and walking >5,000 steps per day were more frequently observed in those with Stent Fracture than in those without Fracture. Of these variables, walking >5,000 steps per day was the strongest independent determinant associated with Stent Fracture by discriminant analysis (p = 0.0027). Vigorous exercise adversely affects Stent Fracture in patients implanted with a nitinol Stent in the SFA.
Kumiko Hirata - One of the best experts on this subject based on the ideXlab platform.
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serial angiographic findings and prognosis of Stent Fracture site without early restenosis after sirolimus eluting Stent implantation
American Heart Journal, 2010Co-Authors: Yasushi Ino, Takashi Kubo, Yasuaki Toyoda, Atsushi Tanaka, Shuuta Ishii, Yoshio Kusuyama, Shigeho Takarada, Hironori Kitabata, Takashi Tanimoto, Kumiko HirataAbstract:Background Stent Fracture is one of the possible causes of in-Stent restenosis after sirolimus-eluting Stent (SES) implantation. However, long-term prognosis including late restenosis in Stent Fracture site without early restenosis remains unknown. The aim of this study is to investigate the risk of late restenosis at the Stent Fracture site without early restenosis after SES implantation. Methods We divided 366 patients with 490 lesions into 2 groups with or without Stent Fracture based on the first scheduled follow-up coronary angiography (Fracture group, 21 lesions; nonFracture group, 469 lesions). The second scheduled follow-up coronary angiography (>15 months after SES implantation) was performed in 83 patients with 124 lesions. Results Target lesion revascularization due to late restenosis at the Stent Fracture site did not occur in the Fracture group, but occurred in 5 lesions in the nonFracture group. At the first follow-up, minimal luminal diameter was significantly smaller and percentage diameter stenosis was significantly larger in the Fracture group (1.98 ± 0.41 vs 2.52 ± 0.49 mm, P = .001 and 30.5% ± 13.1% vs 13.0% ± 8.8%, P P = .01 and P = .007, respectively). In each group, there were no significant changes in minimal luminal diameter, percentage diameter stenosis, and late lumen loss between the first and second follow-up. Conclusions Late restenosis was not observed in Stent Fracture sites without early restenosis during the midterm follow-up after SES implantation.