Massive Audio PAT50 User Manual download pdf (Page 14)

152 J KARDIOL 2008; 15 (5–6)

ÖKG-Jahrestagung – Abstracts

Methods After general anaesthesia, 8 domestic pigs were sub-

jected to 2× 30 sec Dior balloon (3.0 or 2.75 mm of size, 15 mm of

length) dilatation of the left anterior (LAD), left circumflex (mid

portion after the first side branch) and proximal right coronary arter-

ies. Bifurcation intervention followed by kissing balloon dilatation

was performed in 6 arteries. Non-coated balloon dilatation of the

LAD in additional pigs served as control. After euthanasia, the

dilated segments of the coronary arteries, the distal and proximal

reference segments were prepared for measurement of tissue

paclitaxel concentration using HPLC. Plasma samples were taken

10, 20, 30, 60, 120 min while tissue samples were harvested mean

1.5h, 12h, 24h and 48 h after balloon dilatation, respectively. The

dilated arterial sections were subjected to TUNEL immunochemis-

try and the apoptotic smooth muscle cells were counted as a percent

of total cells 48 h post-dilatation.

Results The tissue paclitaxel concentration of the single dilated

segment was 1.82 ± 1.60 μM/L 1.5 h post-dilatation, and decreased

significantly to 0.73 ± 0.27 (p = 0.032), 0.62 ± 0.34 and 0.44 ±

0.31 μM/L after 12, 24 and 48 h. The bifurcation intervention re-

sulted in 5.10 ± 1.80 μM/L tissue paclitaxel dosis of the main

branch, which decreased at 12 h to 1.41 ± 1.23 μM/L (p = 0.004).

The bifurcation side branch tissue contained 7.00 ± 4.80 μM/L

paclitaxel 1.5 h post-dilatation, which was decreased to 2.72 ±

0.40 μM/L (p = 0.034). The mean paclitaxel concentration of the

reference segments decreased gradually from 0.84 ± 0.99 to 0.34 ±

0.36 μM/L (p = 0.09), and further to 0.28 ± 0.16 and 0.19 ±

0.18 μM/L tissue 1.5, 12, 24 and 48 h post-dilatation, respectively.

No paclitaxel was found in the peripheral blood 10, 20, 30 min, 1 h,

2 h, 12 h, 24 h and 48 h after Dior balloon dilatation. Mild increase

in cell proliferation within the media was found in arterial segments

dilated with coated and non-coated balloon. Increased number of

apoptotic cells (4.4 ± 0.8 % vs 2.5 ± 0.9 %; p < 0.05) in the media

was found in coated balloon-treated vessels as compared with the

arteries dilated with non-coated balloon.

Conclusions Short exposition of coronary artery to paclitaxel by

local drug delivery with coated balloon is sufficient to reach ad-

equate tissue concentration of paclitaxel in order to exert antipro-

liferative effect.

Comparison of Early and Late Combined Cardiac

Application of Bone Marrow Mononuclear Stem

Cells after Myocardial Infarction: Results of the

MYSTAR Prospective Randomized Study 094

M. Gyöngyösi

, M. Dettke

, I. M. Lang

, H. Sochor

S. Graf

, S. Charwat

N. Nyolczas

, G. Sodeck

, G. Christ

, G. Beran

, A. Kaider

, S. Zamini

, A. Khorsand

G. Maurer

, D. Glogar

Department of Cardiology;

Department of Transfusion Medicine;

Department of

Emergency Medicine;

Institute of Clinical Biometrics, Medical University of Vienna

Background In MYSTAR study, results of combined delivery of

autologous bone marrow-derived mononuclear cells (BM-MNCs)

were compared in patients with recent acute myocardial infarction

(AMI).

Methods Patients with left ventricular (LV) ejection fraction (EF)

< 45 % after AMI were randomized to Early or Late (32 ± 12 or 93

± 15 days post-AMI) groups. Primary endpoints of the study are

changes in infarct size and global EF 3 months after BM-MNCs

therapy. Secondary endpoints include safety, feasibility, changes in

LV segmental motion, myocardial viability, end-diastolic, end-

systolic volumes and clinical symptoms.

Results Patients in Early vs Late groups received NOGA-guided

intramyocardial injections of 476 × 10

(363; 840 × 10

; median

with first quartiles) vs 648 × 10

(408; 956 × 10

) BM-MCs followed

by intracoronary injections of 2614 × 10

(1996; 3795 × 10

) vs

3049 × 10

(2223; 5086 × 10

) BM-MNCs into the open infarct-re-

lated artery. The mean (± SD) change (between pre-treatment and

control) in infarct size was –3.5 ± 5.1 % (95 % confidence interval

[CI]: –5.5 to –1.5; p = 0.001) vs –3.9 ± 5.6 % (95 %-CI –6.1 to –1.6;

p = 0.002) and in EF 3.5 ± 5.6 % (95 %-CI: 1.3 to 5.6; p = 0.003) vs

3.4 ± 7.0 % (95 %-CI: 0.7 to 6.1; p = 0.017) in Early vs Late groups,

without significant difference between the groups. Myocardial

viability and NYHA improved significantly in both groups, with no

change in the other secondary endpoints. Frequency distribution

analysis revealed, that the infarct size decreased by at least 5 % in

36.7 % of the patients in the Early group and in 30 % of those in the

Late group. An improvement of least 5 % in global EF was meas-

ured in 40 % of the patients in the Early group and 30 % in the Late

group. Multivariate analysis revealed total number of intramyo-

cardially delivered BM-MNCs and CD34+ cells to be significant

predictor of improvement in infarct size and EF, respectively.

Conclusions Combined delivery of unselected BM-MNCs in-

duce a moderate but significant improvement in myocardial infarct

size and LV function, paired with significant improvement in myo-

cardial viability.

Short- and Long-Term Outcome of Yukon DES Im-

plantation in a Real World Setting: Results of the

Single-Center Yukon Registry 114

R. Hemetsberger, M. Gyöngyösi, S. Winkler, M. Freynhofer, I. M. Lang, G. Christ,

G. Kreiner, T. Neunteufl, H. Sochor, D.Glogar

Division of Cardiology, Department of Internal Medicine II, Medical University of

Vienna

Background Rapamycin is one of the most powerful substances

to inhibit intimal poliferation and reduce in-stent restenosis. In-spite

of proven beneficial effect of the rapamycin-coated Cypher stent on

angiographic and clinical outcome of percutaneous coronary inter-

vention (PCI), the delayed endothelialization and consequent late

thrombosis might hamper the use of this polymer-based drug-elut-

ing stent (DES). The Yukon stent with its microporous (PEARL)

surface allows the drug adsorption to the stent without polymer, re-

sulting in a faster re-endothelialization without polymer remnant.

The aim of the present study was to assess the angiographic and

clinical outcomes of implantation of rapamycine (2 % rapamycin

solution resulting in 2.2 μg/mm

stent + balloon surface) – coated

Yukon stents.

Methods Sixty-seven patients (73 % male) with 73 significant

coronary stenoses were included in the Registry. In accordance with

the nature of the Registry, no exclusion criteria were defined. Six-

month angiographic follow-up (FUP) was performed in 65 % of

patients, clinical FUP in all patients. Baseline and FUP quantitative

angiographic parameters were measured. The occurrences of short-

(acute stent thrombosis) and long-term major adverse cardiac

events (MACE, cardiac death, acute myocardial infarction and tar-

get lesion revascularization: TLR) were recorded.

Results Totally, 105 Yukon stents were implanted (34 % in LAD,

25 % in LCx, 33 % in RCA and 8 % in bypass vessels) in 28 patients

(42 %) with acute coronary syndrome, 2 patients (3 %) in cardio-

genic shock and 37 patients (55 %) with stable angina pectoris. The

stents/lesion ratio was 1.44 with 1.57 stent/patient ratio. There was

no procedural complication. Subacute stent thrombosis occurred

6 days post-stenting in a 80 year old patient with STEMI during the

index procedure. During the FUP, 3 patients died, 2 of them with

initial cardiogenic shock, and one due to terminal renal insuffi-

ciency. Thus the cardiac death was 3 % (non-stent related). TLR

was performed in 10 patients (14.9 %), with a composite MACE of

17.9 %. The pre, post-stent and FUP minimal lumen diameter was

1.01 ± 0.39, 2.54 ± 0.39 and 2.11 ± 0.55 mm, and the percent diam-

eter stenosis 63 ± 12, 17 ± 8 and 24 ± 16 %. The acute lumen gain

was 1.43 ± 0.97 mm, the in-stent late lumen loss 0.41 ± 0.44 mm.

The binary restenosis rate was 11.4 %.

Conclusions The polymer-free coating of the stent with rapa-

mycin results in a similar angiographic and clinical outcome as ob-

served in other DES in real-world setting.

1 2 ... 9 10 11 12 13 14 15 16 17 18 19 ... 45 46

Comments to this Manuals

No comments

Massive Audio PAT50 User Manual Page 14

Comments to this Manuals

Related products and manuals for Unknown Massive Audio PAT50