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A coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes.
Restenosis is the recurrence of stenosis, a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage and subsequently become renarrowed. This is usually restenosis of an artery, or other blood vessel, or possibly a vessel within an organ.
Coronary thrombosis is defined as the formation of a blood clot inside a blood vessel of the heart. This blood clot may then restrict blood flow within the heart, leading to heart tissue damage, or a myocardial infarction, also known as a heart attack.
Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowing of the coronary arteries of the heart found in coronary artery disease. The process involves combining coronary angioplasty with stenting, which is the insertion of a permanent wire-meshed tube that is either drug eluting (DES) or composed of bare metal (BMS). The stent delivery balloon from the angioplasty catheter is inflated with media to force contact between the struts of the stent and the vessel wall, thus widening the blood vessel diameter. After accessing the blood stream through the femoral or radial artery, the procedure uses coronary catheterization to visualise the blood vessels on X-ray imaging. After this, an interventional cardiologist can perform a coronary angioplasty, using a balloon catheter in which a deflated balloon is advanced into the obstructed artery and inflated to relieve the narrowing; certain devices such as stents can be deployed to keep the blood vessel open. Various other procedures can also be performed.
A drug-eluting stent (DES) is a peripheral or coronary stent placed into narrowed, diseased peripheral or coronary arteries that slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombi), could otherwise block the stented artery, a process called restenosis. The stent is usually placed within the peripheral or coronary artery by an interventional cardiologist or interventional radiologist during an angioplasty procedure.
Phosphorylcholine is the hydrophilic polar head group of some phospholipids, which is composed of a negatively charged phosphate bonded to a small, positively charged choline group. Phosphorylcholine is part of platelet-activating factor; the phospholipid phosphatidylcholine as well as sphingomyelin, the only phospholipid of the membrane that is not built with a glycerol backbone. Treatment of cell membranes, like those of RBCs, by certain enzymes, like some phospholipase A2 renders the phosphorylcholine moiety exposed to the external aqueous phase, and thus accessible for recognition by the immune system. Antibodies against phosphorylcholine are naturally occurring autoantibodies that are created by CD5+/B-1 B cells and are referred to as non-pathogenic autoantibodies.
The history of invasive and interventional cardiology is complex, with multiple groups working independently on similar technologies. Invasive and interventional cardiology is currently closely associated with cardiologists, though the development and most of its early research and procedures were performed by diagnostic and interventional radiologists.
Biosensors International Group is a medical device company that specializes in developing, manufacturing and licensing technologies for use in interventional cardiology procedures and critical care. The company was listed in the Mainboard of the Singapore Exchange (SGX) in May 2005. The global headquarters of the company are located in Singapore, where the main manufacturing facilities and R&D centers are hosted. The European headquarters are in Morges, Switzerland; this Swiss office is also the Legal Manufacturer of BioMatrix, the current leading product of the company.
A coronary stent is a tube-shaped device placed in the coronary arteries that supply blood to the heart, to keep the arteries open in the treatment of coronary heart disease. It is used in a procedure called percutaneous coronary intervention (PCI). Coronary stents are now used in more than 90% of PCI procedures. Stents reduce angina and have been shown to improve survivability and decrease adverse events in an acute myocardial infarction.
Cypher is a brand of drug-eluting coronary stent from Cordis Corporation, a Cardinal Health company. During a balloon angioplasty, the stent is inserted into the artery to provide a "scaffold" to open the artery. An anti-rejection-type medication, sirolimus, helps to limit the overgrowth of normal cells while the artery heals which reduces the chance of re-blockage in the treated area known as restenosis, and reduces the chances that another procedure is required.
Zotarolimus is an immunosuppressant. It is a semi-synthetic derivative of sirolimus (rapamycin). It was designed for use in stents with phosphorylcholine as a carrier. Zotarolimus, or ABT-578, was originally used on Abbott's coronary stent platforms to reduce early inflammation and restenosis; however, Zotarolimus failed Abbott's primary endpoint to bring their stent/drug delivery system to market. The drug was sold/distributed to Medtronic for use on their stent platforms, which is the same drug they use today. Coronary stents reduce early complications and improve late clinical outcomes in patients needing interventional cardiology. The first human coronary stent implantation was first performed in 1986 by Puel et al. However, there are complications associated with stent use, development of thrombosis which impedes the efficiency of coronary stents, haemorrhagic and restenosis complications are problems associated with stents.
Nitinol biocompatibility is an important factor in biomedical applications. Nitinol (NiTi), which is formed by alloying nickel and titanium, is a shape-memory alloy with superelastic properties more similar to that of bone, when compared to stainless steel, another commonly used biomaterial. Biomedical applications that utilize Nitinol include stents, heart valve tools, bone anchors, staples, septal defect devices and implants. It is a commonly used biomaterial especially in the development of stent technology.
Bare-metal stent is a stent without a coating or covering. It is a mesh-like tube of thin wire. The first stents licensed for use in cardiac arteries were bare metal – often 316L stainless steel. More recent stents use cobalt chromium alloy. The first stents used in gastrointestinal conditions of the esophagus, gastroduodenum, biliary ducts, and colon were plastic; bare metal stents were first brought into the clinic in the 1990s.
In medicine, a stent is any device which is inserted into a blood vessel or other internal duct to expand it to prevent or alleviate a blockage. Traditionally, such devices are fabricated from metal mesh and remain in the body permanently or until removed through further surgical intervention. A bioresorbable stent serves the same purpose, but is manufactured from a material that may dissolve or be absorbed in the body.
Nicholas George Kounis is professor emeritus of cardiology in the University of Patras and scientific cardiology advisor at Saint Andrews State General Hospital Patras and at the Department of cardiology of University of Patras Medical School, Patras, Greece.
Alvimedica is a manufacturer of coronary stents, balloon catheters, diagnostic and guiding catheters. The company was founded in 2007 by Turkish businessmen and scientists living in Denmark and Sweden. The major intention of the company is investing in small and medium size medical device manufacturers to enable them to compete globally. The company made its first investment move by purchasing a medical device company called Nemed in Turkey in 2007. Following this, the company purchased an American company called In-Vivo, a manufacturer of angioplasty and angiography catheters, and one of the suppliers of Abbott Laboratories.
OrbusNeich is a global pioneer in the provision of life-changing vascular solutions and offers an extensive portfolio of products that set industry benchmarks in vascular intervention.
A dual therapy stent is a coronary artery stent that combines the technology of a bioengineered stent and a drug eluting stent to both accelerate healing of the vessel and to block cell proliferation.
Daljeet Singh Gambhir is an Indian cardiologist, medical academic, researcher and inventor and the Group Director of Cardiology at Kailash Group of Hospitals and Heart Institute, Delhi. He is the inventor of Infinnium Paclitaxel-Eluting Stent, a reportedly cheaper drug-eluting stent which he first presented at the EuroPCR meeting held in Paris in 2003. A fellow of the National Academy of Medical Sciences and an honorary fellow of the Indian College of Cardiology, he is reported to have performed over 10,000 coronary interventions. The Government of India awarded him the fourth highest civilian honour of the Padma Shri, in 2016, for his contributions to medicine.
MicroPort is a global medical device developer and manufacturer that is headquartered in Shanghai, China. It designs and produces products for a range of medical fields including cardiology, interventional radiology, orthopedics, electrophysiology, and surgical management. MicroPort is considered to be among the top 100 medical device companies in 2018 and was selected to be the 2017 China Innovative Medical Device Company.
References
- ↑ Bylander, Jessica (27 October 2008). "New Stents On The Block: Innovators Look Beyond Drug Coatings." The Gray Sheet.
- ↑ "Novel stent promotes healing of vessel wall after implantation" Cardiology Today
- ↑ Klomp M, Beijk MA, de Winter RJ (July 2009). "Genous™ endothelial progenitor cell-capturing stent system: a novel stent technology". Expert Review of Medical Devices. 6 (4): 365–375. doi:10.1586/erd.09.16. PMID 19572791. S2CID 22534986 . Retrieved 28 August 2012.
- ↑ "Genous stent is a safe and effective option in STEMI patients" Archived 2013-10-29 at the Wayback Machine Cardiovascular News International
- ↑ London, Susan (14 November 2011). "Bioengineered, Sirolimus-Eluting Stent Found ‘Safe,’ and ‘Effective.’" Cardiology News.
- ↑ "Dual-Therapy Stenting: The Next Step in the Evolution of Stent Design" Cardiology Today: Intervention
- ↑ "TCT: Combo Stent Comparable to Taxus" MedPage Today