BOOK
Coronary Stenting: A Companion to Topol's Textbook of Interventional Cardiology E-Book
(2013)
Additional Information
Book Details
Abstract
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.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| ES2 | IFC2 | ||
| Coronary Stenting: A Companion to Topol's Textbook of Interventional Cardiology | i | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | ix | ||
| Table of Contents | xi | ||
| One Prologue | 1 | ||
| 1 Development of Coronary Stents: | 3 | ||
| Key Points | 3 | ||
| Angioplasty: The Beginnings | 3 | ||
| Genesis of the Metal Graft | 4 | ||
| First Human Case | 5 | ||
| Stent Thrombosis | 6 | ||
| Solving Embolization | 7 | ||
| Randomized Clinical Trials | 7 | ||
| Other Slotted Tube Stents | 9 | ||
| Limitations of the Bare Metal Stent | 9 | ||
| First “Drug-Coated” Stent | 9 | ||
| Modern Drug-Eluting Stents | 10 | ||
| Conclusion | 10 | ||
| References | 10 | ||
| Two Basic Principles | 11 | ||
| 2 Fundamentals of Drug-Eluting Stent Design | 13 | ||
| Key Points | 13 | ||
| Scaffold Design Parameters | 13 | ||
| Scaffold Characteristics | 13 | ||
| Flexibility and Trackability | 13 | ||
| Conformability | 15 | ||
| Radial Strength | 15 | ||
| Longitudinal Strength | 15 | ||
| Recoil | 16 | ||
| Radiopacity | 16 | ||
| Impact of Strut Thickness | 16 | ||
| Stent Alloys | 16 | ||
| Cellular Architecture: Open and Closed Cell Designs | 17 | ||
| Antiproliferative Agents | 17 | ||
| Paclitaxel | 17 | ||
| Rapamycin and Its Analogues | 17 | ||
| Sirolimus | 17 | ||
| Everolimus | 19 | ||
| Zotarolimus | 19 | ||
| Biolimus A9 | 19 | ||
| Polymers | 19 | ||
| Nonerodable Polymers in Clinical Use | 20 | ||
| Poly(styrene-b-isobutylene-b-styrene) | 20 | ||
| Poly(ethylene-co-vinyl acetate) and Poly(n-butyl methacrylate) Blend | 21 | ||
| Vinylidene Fluoride and Hexafluoropropylene Copolymer | 21 | ||
| Phosphorylcholine Polymer | 22 | ||
| BioLinx | 22 | ||
| Drug-Eluting Stents | 23 | ||
| Cypher | 23 | ||
| Taxus Express and Taxus Liberté | 24 | ||
| Promus Element | 24 | ||
| Taxus Element (ION) | 25 | ||
| Xience Series | 26 | ||
| Endeavor | 27 | ||
| Resolute Integrity | 27 | ||
| Conclusions | 27 | ||
| References | 28 | ||
| 3 Preclinical Evaluation of Coronary Stents | 30 | ||
| Key Points | 30 | ||
| Historical Background | 30 | ||
| Animal Models Used for Stent Validation Testing | 30 | ||
| Normal Swine Models | 30 | ||
| Atherosclerotic Animal Models and Stent Efficacy | 31 | ||
| Evaluation of Bare Metal Stents | 31 | ||
| Arterial Overstretch and Porcine Model of Stent Restenosis | 31 | ||
| Inflammation after Bare Metal Stent Implantation | 32 | ||
| Temporal Response after Bare Metal Stent Implantation | 32 | ||
| Methodologies for Preclinical Testing of Bare Metal Stents | 32 | ||
| Evaluation of Drug-Eluting Stents | 34 | ||
| Key Concepts of Drug-Eluting Stent Validation | 34 | ||
| Polymers | 35 | ||
| Drug-Release Kinetics | 36 | ||
| Preclinical Assessment of Combined Drug-Eluting Stent Platform (Polymer, Drug, and Stent) | 36 | ||
| Preclinical Assessment of Sirolimus-Eluting and Paclitaxel-Eluting Stents | 37 | ||
| Newer Generation Drug-Eluting Stents | 38 | ||
| Bioresorbable Scaffolds and Bioabsorbable Stents | 39 | ||
| Initial Bench Testing | 39 | ||
| Preclinical Animal Testing | 39 | ||
| Endovascular Imaging Versus Histomorphometry | 40 | ||
| Measures of Efficacy for Bioresorbable Scaffolds | 40 | ||
| Specific Bioresorbable Technologies | 40 | ||
| ABSORB Bioresorbable Vascular Scaffold | 41 | ||
| Bioresorbable Magnesium Alloy Stent | 41 | ||
| ReZolve Sirolimus-Eluting Bioresorbable Coronary Scaffold | 41 | ||
| Conclusion | 41 | ||
| References | 42 | ||
| 4 Design, Analysis, and Interpretation of Comparative Effectiveness Studies and Randomized Clinical Trials of Coronary Stents | 44 | ||
| Key Points | 44 | ||
| Introduction | 44 | ||
| Fundamentals of Clinical Trials Evaluating Coronary Stents | 44 | ||
| What is the Question? | 44 | ||
| Minimizing Variation | 45 | ||
| Stratified Randomization | 45 | ||
| Randomization and Comparators | 45 | ||
| Blinding | 45 | ||
| Equipoise | 45 | ||
| Selection of Comparators | 45 | ||
| Endpoints | 46 | ||
| Angiographic Endpoints | 46 | ||
| Clinical Endpoints | 46 | ||
| Monitoring Trial Progress and Performing Interim Analyses | 46 | ||
| Patient Populations | 46 | ||
| Analysis of Randomized Clinical Trial Data | 47 | ||
| Principle of Intention to Treat | 48 | ||
| Per-Protocol Analyses | 48 | ||
| Subgroup Analyses | 48 | ||
| Limitations and Disadvantages of Randomized Clinical Trials | 48 | ||
| Case Study: The TAXUS Paclitaxel-Eluting Stent Randomized Clinical Trial Program | 48 | ||
| More Recent Trends in Randomized Clinical Trials of Drug-Eluting Stents | 49 | ||
| All Comers Trials | 49 | ||
| Single-Arm Trials with Historical Controls | 51 | ||
| Equivalence and Noninferiority Trials | 52 | ||
| Example of a Noninferiority Trial of Coronary Stents: PLATINUM Trial | 52 | ||
| Control Arms in Noninferiority Studies | 52 | ||
| Noninferiority Margin | 52 | ||
| Intention to Treat and Per-Protocol Analyses in Noninferiority Trials | 52 | ||
| Observational Studies to Determine Comparative Effectiveness | 52 | ||
| Analytical Strategies for Nonrandomized Comparative Effectiveness Studies | 53 | ||
| Cohort Studies | 53 | ||
| Case-Control Studies | 53 | ||
| Analytical Control for Confounding | 53 | ||
| Stratified Analyses | 53 | ||
| Regression Analyses | 53 | ||
| Propensity Scores | 54 | ||
| Instrumental Variable Analyses | 54 | ||
| Case Study of Methods to Control for Confounding: is There a Mortality Benefit with Drug-Eluting Stents Compared with Bare Metal Stents? | 54 | ||
| Other Types of Studies | 56 | ||
| Systematic Reviews | 56 | ||
| Meta-Analyses | 56 | ||
| Network Meta-Analyses | 56 | ||
| Conclusion | 56 | ||
| References | 57 | ||
| 5 Pathology of Drug-Eluting Stents in Humans | 59 | ||
| Key Points | 59 | ||
| Introduction | 59 | ||
| Endothelial Coverage as a Morphometric Predictor for Late and Very Late Stent Thrombosis | 59 | ||
| Delayed Arterial Healing in First-Generation Drug-Eluting Stents Implanted for Acute Myocardial Infarction | 60 | ||
| Culprit Stent Thrombosis Sites in Patients Treated with Drug-Eluting Stents for Acute Myocardial Infarction Compared with Stable Angina | 60 | ||
| Culprit Sites Compared with Nonculprit Sites | 60 | ||
| Fibrous Cap Thickness and Stent Strut Coverage | 60 | ||
| Pathologic Findings in Bifurcation Stenting | 63 | ||
| Impact of Stent Fracture on Adverse Pathologic Findings | 64 | ||
| Coronary Responses and Differential Mechanisms of Late and Very Late Stent Thrombosis Attributed to Sirolimus-Eluting Stents and Paclitaxel-Eluting Stents | 64 | ||
| Late Increases in Neointima after Drug-Eluting Stent Implantation | 67 | ||
| Comparative Pathology of Neoatherosclerosis after Bare Metal Stent or Drug-Eluting Stent Implantation | 67 | ||
| Conclusion | 69 | ||
| References | 69 | ||
| 6 Bioresorbable Coronary Scaffolds | 71 | ||
| Key Points | 71 | ||
| Potential Advantages of Bioresorbable Scaffolds | 71 | ||
| Bioresorbable Scaffold Technologies | 72 | ||
| Igaki-Tamai Bioabsorbable Scaffold | 72 | ||
| Bioabsorbable Magnesium Stent | 72 | ||
| ABSORB Everolimus-Eluting Bioresorbable Vascular Scaffold | 73 | ||
| Cohort A Design and Outcomes | 73 | ||
| Cohort B Design and Outcomes | 74 | ||
| Side Branches | 75 | ||
| Future Studies | 75 | ||
| REVA Bioabsorbable Stent | 75 | ||
| Elixir Bioresorbable Scaffold | 75 | ||
| Arterial Remodeling Technologies | 76 | ||
| Summary | 77 | ||
| References | 77 | ||
| Three Clinical Use | 79 | ||
| 7 Efficacy and Safety of Bare Metal and Drug-Eluting Stents | 81 | ||
| Key Points | 81 | ||
| Introduction | 81 | ||
| Bare Metal Stents | 81 | ||
| Drug-Eluting Stents | 82 | ||
| First-Generation Drug-Eluting Stents | 82 | ||
| Sirolimus-Eluting Stent | 82 | ||
| Paclitaxel-Eluting Stent | 83 | ||
| Second-Generation Drug-Eluting Stents | 83 | ||
| Everolimus-Eluting Stents | 84 | ||
| Xience V/Promus | 84 | ||
| Promus Element | 84 | ||
| Zotarolimus-Eluting Stents | 84 | ||
| Endeavor | 84 | ||
| Resolute | 87 | ||
| Biolimus A9-Eluting Stents | 87 | ||
| Comparisons of Drug-Eluting Stents versus Bare Metal Stents and Concerns Regarding Safety of Drug-Eluting Stents | 88 | ||
| Conclusion: Balancing Safety and Efficacy | 89 | ||
| References | 90 | ||
| 8 Clinical Presentation, Evaluation, and Treatment of Restenosis | 93 | ||
| Key Points | 93 | ||
| Introduction | 93 | ||
| Definition | 93 | ||
| Pathophysiology | 93 | ||
| Factors Contributing to Restenosis | 94 | ||
| Biologic Factors | 94 | ||
| Drug Resistance | 94 | ||
| Hypersensitivity | 94 | ||
| Mechanical Factors | 94 | ||
| Stent Underexpansion | 94 | ||
| Nonuniform Drug Distribution | 95 | ||
| Stent Fracture | 95 | ||
| Technical Factors | 96 | ||
| Geographic Miss and Barotrauma Outside Stented Segment | 96 | ||
| Stent Gap | 96 | ||
| Incidence | 96 | ||
| Bare Metal Stents | 96 | ||
| Drug-Eluting Stents | 96 | ||
| First-Generation Drug-Eluting Stents | 96 | ||
| Sirolimus-Eluting Stent | 96 | ||
| Paclitaxel-Eluting Stent | 96 | ||
| Second-Generation Drug-Eluting Stents | 96 | ||
| Zotarolimus-Eluting Stent | 96 | ||
| Everolimus-Eluting Stent | 96 | ||
| Predictors of Restenosis | 98 | ||
| Patient-Related Factors | 98 | ||
| Lesion-Related Factors | 98 | ||
| Procedure-Related Factors | 98 | ||
| Clinical Presentation | 98 | ||
| Bare Metal Stent Restenosis | 98 | ||
| Drug-Eluting Stent Restenosis | 99 | ||
| TIMEFRAME FOR DEVELOPMENT OF IN-STENT RESTENOSIS | 99 | ||
| Evaluation | 99 | ||
| Noninvasive Evaluation of in-Stent Restenosis | 99 | ||
| Invasive Evaluation of in-Stent Restenosis | 99 | ||
| Patterns of in-Stent Restenosis | 100 | ||
| Prognosis | 100 | ||
| Treatment | 101 | ||
| Preventive Therapy | 101 | ||
| Cilostazol | 101 | ||
| Pioglitazone | 101 | ||
| Treatment of in-Stent Restenosis | 101 | ||
| Treatment of Bare Metal Stent Restenosis | 101 | ||
| Treatment of Drug-Eluting Stent Restenosis | 102 | ||
| Same Drug-Eluting Stent or Different Drug-Eluting Stent | 102 | ||
| Vascular Brachytherapy | 102 | ||
| Drug-Eluting Balloon Catheters | 102 | ||
| Conclusion | 103 | ||
| References | 103 | ||
| 9 Intravascular Ultrasound–Guided Coronary Stent Implantation | 107 | ||
| Key Points | 107 | ||
| Introduction | 107 | ||
| Criteria for Optimal Stent Implantation | 107 | ||
| Intravascular Ultrasound–Guided Implantation of Bare Metal Stents | 108 | ||
| Impact of Intravascular Ultrasound on Bare Metal Stent Restenosis and Target Lesion Revascularization | 108 | ||
| Clinical Trials of Intravascular Ultrasound–Guided Percutaneous Coronary Intervention with Bare Metal Stents | 108 | ||
| Meta-analyses | 109 | ||
| Impact of Intravascular Ultrasound on Bare Metal Stent Thrombosis | 109 | ||
| Predictors of Stent Thrombosis | 109 | ||
| Cost-Effectiveness of Intravascular Ultrasound during Percutaneous Coronary Intervention with Bare Metal Stents | 109 | ||
| Intravascular Ultrasound–Guided Implantation of Drug-Eluting Stents | 111 | ||
| Impact of Intravascular Ultrasound on Drug-Eluting Stent Restenosis | 111 | ||
| Other Mechanisms of Drug-Eluting Stent Restenosis | 112 | ||
| Nominal Balloon Inflation Pressure and Predicted Minimal Stent Diameter | 112 | ||
| Drug-Eluting Stent Treatment of Bare Metal In-Stent Restenosis | 112 | ||
| Impact of Intravascular Ultrasound on Stent Thrombosis | 112 | ||
| Early Drug-Eluting Stent Thrombosis | 112 | ||
| Late and Very Late Stent Thrombosis | 113 | ||
| Clinical Impact of Intravascular Ultrasound Guidance for Drug-Eluting Stent Implantation | 113 | ||
| Observational Registries | 113 | ||
| Randomized Trials | 114 | ||
| Guideline Recommendations | 114 | ||
| Conclusion | 114 | ||
| References | 115 | ||
| 10 Optical Coherence Tomography: | 116 | ||
| Key Points | 116 | ||
| Introduction | 116 | ||
| Basic Principles of Optical Coherence Tomography | 116 | ||
| Axial and Lateral Resolution | 116 | ||
| Time-Domain and Frequency-Domain Optical Coherence Tomography | 116 | ||
| Optical Coherence Tomography–Guided Coronary Intervention | 116 | ||
| Image Acquisition | 116 | ||
| Vessel and Stent Assessment | 118 | ||
| Safety of Optical Coherence Tomography | 120 | ||
| Imaging Artifacts | 120 | ||
| Stent Analysis and Evaluation | 121 | ||
| Z-Offset | 121 | ||
| Assessment of Optical Coherence Tomography Stent Images at the Level of a Single Frame | 121 | ||
| Stent Strut Appearance by Optical Coherence Tomography | 121 | ||
| Stent Expansion and Malapposition | 121 | ||
| Dissections | 122 | ||
| Tissue Prolapse | 122 | ||
| Assessment of Optical Coherence Tomography Stent Images at the Level of the Stent Strut | 122 | ||
| Stent Strut Classification | 122 | ||
| Determining Malapposition | 122 | ||
| Special Situations | 123 | ||
| Bifurcations | 123 | ||
| Overlap | 123 | ||
| Future Considerations | 123 | ||
| References | 124 | ||
| 11 Fractional Flow Reserve–Guided Percutaneous Coronary Intervention | 126 | ||
| Key Points | 126 | ||
| Concept and Definition of Fractional Flow Reserve | 126 | ||
| Deferring Percutaneous Coronary Intervention Based on Fractional Flow Reserve | 126 | ||
| Fractional Flow Reserve in Specific Lesion Subsets | 127 | ||
| Left Main Disease | 127 | ||
| Bifurcation Side Branches | 128 | ||
| Serial Lesions | 128 | ||
| Diffuse Disease | 128 | ||
| Fractional Flow Reserve in Multivessel Disease | 128 | ||
| Limitations of Fractional Flow Reserve | 130 | ||
| References | 131 | ||
| 12 Optimal Antithrombotic Therapy | 133 | ||
| Key Points | 133 | ||
| Pathophysiology of Atherothrombosis | 133 | ||
| Antiplatelet Therapy | 133 | ||
| Cyclooxygenase Inhibitor: Aspirin | 133 | ||
| Mechanisms of Action | 133 | ||
| Indications | 135 | ||
| Side Effects | 136 | ||
| P2Y12 Inhibitors | 136 | ||
| Mechanisms of Action | 136 | ||
| Four Specific Lesion Subsets | 153 | ||
| 13 The Role of Drug-Eluting Stents or Cardiac Bypass Surgery in the Treatment of Multivessel Coronary Artery Disease | 155 | ||
| Key Points | 155 | ||
| Observational Studies Comparing Drug-Eluting Stents with Cardiac Surgery | 155 | ||
| Modern Randomized Clinical Trials of Stenting Versus Surgery | 156 | ||
| Multicenter Registries with Historical Coronary Artery Bypass Grafting Controls from Earlier Randomized Trials | 156 | ||
| ARTS II | 156 | ||
| ERACI III | 156 | ||
| Prospective, Randomized Clinical Trials | 157 | ||
| SYNTAX Trial | 157 | ||
| Design and Patient Characteristics | 157 | ||
| Clinical Outcomes | 158 | ||
| Special Populations: Diabetes | 158 | ||
| CARDia Trial | 158 | ||
| Design and Patient Characteristics | 158 | ||
| Clinical Outcomes | 160 | ||
| FREEDOM Trial | 161 | ||
| Risk Prediction Models for Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting | 161 | ||
| Risk Scores Incorporating Clinical Variables Alone | 161 | ||
| Age, Creatinine, and Ejection Fraction Score | 161 | ||
| EuroSCORE | 163 | ||
| Mayo Clinic Risk Score | 163 | ||
| Risk Scores Incorporating Anatomic Variables Alone | 163 | ||
| SYNTAX Score | 163 | ||
| Functional SYNTAX score | 163 | ||
| Risk Scores Incorporating Anatomic and Clinical Variables | 163 | ||
| Global Risk Classification | 163 | ||
| Clinical SYNTAX Score | 163 | ||
| Society of Thoracic Surgery Score | 163 | ||
| Summary of Using Risk Stratification Scores to Select Appropriate Revascularization Strategy | 164 | ||
| Society Guidelines | 164 | ||
| Future Directions | 164 | ||
| Conclusion | 165 | ||
| References | 165 | ||
| 14 Left Main Coronary Artery Stenting | 167 | ||
| Key Points | 167 | ||
| Current Guidelines | 167 | ||
| Risk Stratification | 167 | ||
| Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting | 167 | ||
| Lesion Assessment and Imaging | 169 | ||
| Lesion Subsets and Stenting Techniques | 169 | ||
| Type of Stent | 172 | ||
| Further Considerations | 172 | ||
| Hemodynamic Support | 172 | ||
| Dual Antiplatelet Therapy | 173 | ||
| Surveillance | 173 | ||
| Conclusion | 174 | ||
| References | 174 | ||
| 15 Stenting Approaches to the Bifurcation Lesion | 176 | ||
| Key Points | 176 | ||
| Introduction and Historical Perspective | 176 | ||
| Atherosclerosis in Coronary Bifurcations | 176 | ||
| Distribution | 176 | ||
| Endothelial Shear Stress | 177 | ||
| Blood Flow Patterns | 177 | ||
| Endothelial Shear Stress and Arterial Plaque Formation | 177 | ||
| Vascular Profiling | 178 | ||
| Bifurcation Lesion Definition, Geometry, and Classification | 178 | ||
| Definition | 178 | ||
| Bifurcation Geometry and Reference Vessel Size Prediction | 179 | ||
| Lesion Classification | 179 | ||
| Medina Classification | 179 | ||
| Movahed Classification | 179 | ||
| Classification of the Left Main Bifurcation | 179 | ||
| Bifurcation Stenting Techniques | 180 | ||
| Technique Classification | 180 | ||
| Initial Strategy and Decision Making | 181 | ||
| Main Branch Stenting Only | 183 | ||
| Provisional Side Branch Stenting | 183 | ||
| Two-Stent Strategy | 183 | ||
| Procedural Considerations | 184 | ||
| Arterial Access and Guiding Catheter | 184 | ||
| Arterial Approach | 184 | ||
| Choice of Coronary Guidewires and Wiring Techniques | 184 | ||
| Dedicated Two-Stent Techniques | 184 | ||
| T Stenting | 184 | ||
| Classic T Stenting | 184 | ||
| Modified T Stenting | 184 | ||
| Reverse T Stenting | 184 | ||
| T Stenting and Protrusion | 184 | ||
| Culotte Technique | 185 | ||
| Crush Technique | 185 | ||
| Step Crush Technique | 186 | ||
| Reverse Crush Technique | 186 | ||
| Double Kissing Crush Technique | 186 | ||
| V-Stent, Simultaneous Kissing Stent, and Trouser Simultaneous Kissing Stent Techniques | 187 | ||
| Clinical Outcomes of Bifurcation Stenting | 188 | ||
| Provisional Stenting Versus Double Stenting | 188 | ||
| Final Kissing Balloon Inflation and Outcomes | 190 | ||
| Plaque Modification | 190 | ||
| Treatment of Unprotected Left Main Coronary Artery Bifurcation | 190 | ||
| Bare Metal Stents | 190 | ||
| Bare Metal Stents Versus Drug-Eluting Stents | 190 | ||
| Complications of Bifurcation Stenting | 191 | ||
| Side Branch Closure | 191 | ||
| Side Branch Restenosis | 191 | ||
| Fracture of a Jailed Wire | 191 | ||
| Stent Embolization | 191 | ||
| Stent Thrombosis | 191 | ||
| Dedicated Bifurcation Stents | 192 | ||
| Classification of Dedicated Bifurcation Stent Devices | 192 | ||
| Intravascular Imaging and Functional Assessment | 192 | ||
| Intravascular Ultrasound | 192 | ||
| Left Main Bifurcation Percutaneous Coronary Intervention | 192 | ||
| Non–Left Main Bifurcation Percutaneous Coronary Intervention | 192 | ||
| Virtual Histology | 192 | ||
| Optical Coherence Tomography | 193 | ||
| Fractional Flow Reserve | 193 | ||
| Conclusion | 194 | ||
| References | 194 | ||
| 16 Chronic Total Occlusions | 197 | ||
| Key Points | 197 | ||
| Background | 197 | ||
| Barriers to CTO-PCI | 197 | ||
| Quality of Life | 197 | ||
| Quantity of Life | 197 | ||
| Complications of Chronic Total Occlusion Intervention | 198 | ||
| Fundamentals of Percutaneous Coronary Intervention for Chronic Total Occlusions | 198 | ||
| Procedural Planning | 198 | ||
| Diagnostic Angiography | 198 | ||
| Vascular Access and Guide Catheters | 198 | ||
| Procedural Anticoagulation | 199 | ||
| Strategic Approach to the Chronic Total Occlusion | 199 | ||
| Coronary Wires | 199 | ||
| Anterograde Wiring | 200 | ||
| Anterograde Dissection and Reentry | 201 | ||
| Bridgepoint | 201 | ||
| CrossBoss Catheter. | 201 | ||
| Stingray Balloon. | 202 | ||
| Stingray Wire. | 202 | ||
| Retrograde Approach | 203 | ||
| Indications for a Retrograde Approach and Appropriate Case Selection | 203 | ||
| Setting Up For Success | 204 | ||
| Review of the Diagnostic Angiogram. | 204 | ||
| Guiding Catheter Selection and Setup. | 204 | ||
| Collateral Angiography. | 204 | ||
| Retrograde Approach Equipment. | 204 | ||
| Wiring Coronary Collaterals. | 205 | ||
| Lesion Crossing. | 205 | ||
| Controlled Anterograde and Retrograde Tracking. | 205 | ||
| Retrograde Recanalization Techniques. | 206 | ||
| Retrieval of Retrograde Equipment. | 207 | ||
| Conclusion | 207 | ||
| References | 207 | ||
| 17 Bypass Graft Intervention | 209 | ||
| Key Points | 209 | ||
| Natural History and Pathology of Vein Graft Disease | 209 | ||
| Approach to Ischemia Following Bypass Surgery | 209 | ||
| Stages of Ischemia after Coronary Artery Bypass Grafting | 209 | ||
| Very Early Ischemia | 209 | ||
| Early Ischemia | 209 | ||
| Late Ischemia | 209 | ||
| Chronic Occlusions | 210 | ||
| Percutaneous Balloon Angioplasty and Stenting | 210 | ||
| Balloon Angioplasty | 210 | ||
| Stenting | 210 | ||
| Bare Metal Stents | 210 | ||
| Drug-Eluting Stents | 210 | ||
| Direct Stenting | 211 | ||
| Adjunctive Devices | 211 | ||
| Embolic Protection | 211 | ||
| Other Devices and Procedural Approaches | 212 | ||
| Rheolytic Thrombectomy | 212 | ||
| Laser Angioplasty | 212 | ||
| Atherectomy | 212 | ||
| Brachytherapy | 214 | ||
| Covered Stents | 214 | ||
| Adjunctive Pharmacotherapy | 214 | ||
| Antithrombotic Strategy | 214 | ||
| Glycoprotein IIB/IIIA Inhibitors | 214 | ||
| Vasodilators | 214 | ||
| Adenosine | 215 | ||
| Nitroprusside | 215 | ||
| Verapamil | 215 | ||
| Nicardipine | 215 | ||
| Fibrinolytics | 215 | ||
| Treatment of Acutely Failed Grafts | 215 | ||
| Conclusions | 217 | ||
| References | 217 | ||
| 18 Stenting in Acute Myocardial Infarction | 219 | ||
| Key Points | 219 | ||
| Bare Metal Stents | 219 | ||
| Stent Trials | 219 | ||
| STENT-PAMI Trial | 219 | ||
| CADILLAC Trial | 219 | ||
| ZWOLLE II Trial | 220 | ||
| Meta-Analyses | 220 | ||
| First-Generation Drug-Eluting Stents | 222 | ||
| Randomized Trials | 222 | ||
| Strategy | 222 | ||
| TYPHOON Trial | 224 | ||
| MULTISTRATEGY Trial | 224 | ||
| HORIZONS AMI Trial | 225 | ||
| Meta-Analysis | 225 | ||
| Temporal Differences in Thrombotic Events | 227 | ||
| Newer Generation Drug-Eluting Stents | 229 | ||
| Everolimus-Eluting Stents | 229 | ||
| Biolimus-Eluting Stents | 230 | ||
| Duration of Dual Antiplatelet Therapy after Coronary Stenting | 230 | ||
| Conclusion | 230 | ||
| References | 232 | ||
| Index | 233 | ||
| A | 233 | ||
| B | 233 | ||
| C | 234 | ||
| D | 234 | ||
| E | 235 | ||
| F | 235 | ||
| G | 235 | ||
| H | 235 | ||
| I | 235 | ||
| J | 235 | ||
| K | 235 | ||
| L | 235 | ||
| M | 235 | ||
| N | 235 | ||
| O | 236 | ||
| P | 236 | ||
| Q | 236 | ||
| R | 236 | ||
| S | 237 | ||
| T | 237 | ||
| U | 237 | ||
| V | 237 | ||
| W | 238 | ||
| X | 238 | ||
| Y | 238 | ||
| Z | 238 | ||
| ES7 | IBC1 |