Benefits on coronary restenosis from elective paclitaxel-eluting stent implantation in patients aged 75 years and older

OBJECTIVE: Elderly patients are increasingly referred for revascularisation yet have been underrepresented in some large clinical trials. Although the advent of drug-eluting stents has dramatically reduced clinical events related to restenosis, older age remains one of the most important correlates of adverse outcome, even after an elective percutaneous coronary intervention (PCI). We sought to evaluate the impact of paclitaxel-eluting stents on coronary restenosis in elderly patients undergoing elective PCI. METHODS: Patients undergoing successful elective PCI with stenting of de novo coronary artery lesions were identified and screened for participation in this study. All patients included in our analysis were divided into two cohort groups: patients aged or=75 years (elderly cohort). We evaluated the six-month incidence of target lesion revascularisation (TLR) and major adverse cardiac events, which included TLR, death and myocardial infarction. RESULTS: A total of 171 (58 aged >or=75 years) consecutive patients were enrolled in the study. At six months, TLR rate was similar in both groups [1.77 vs. 1.72%, odds ratio (OR) 0.97, 95% confidence interval (CI) 0.08-10.9, P = 0.98, in the younger and elderly group, respectively]. Even the rate of major adverse cardiac events was comparable between the two groups (7.96 vs. 8.62%, OR 1.09, 95% CI 0.34-3.41, P = 0.88, in the younger and elderly group, respectively). Also the angiographic restenosis rates were comparable between patients or=75 years (4.42 vs. 3.46%, P = 0.76). CONCLUSIONS: After elective paclitaxel-eluting stent implantation, there is no difference in coronary restenosis in younger and elderly patients, suggesting an age-independent efficacy

Comparison between balloon angioplasty and additional coronary stent implantation for the treatment of drug-eluting stent restenosis: 18-month clinical outcomes

OBJECTIVE: To evaluate the long-term outcomes after different modalities of treatment of drug-eluting stent (DES) in-stent restenosis (ISR) in a 'real world' setting. METHODS: Actually, few and conflicting data are available about the management of in-stent restenosis (ISR) after DES implantation. In our 'real world' registry 1082 consecutive patients who received a DES implantation were included. At 9-month angiographic follow-up, 93 patients presented a DES ISR that was treated with 'homo-DES' (HMD) (N = 27), 'hetero-DES' (HTD) (N = 19) and conventional balloon angioplasty (POBA) (N = 47). We evaluated the clinical outcomes in terms of major adverse cardiac event (MACE) (death, myocardial infarction and target vessel revascularization) at 18 months. RESULTS: There was no difference for clinical and angiographic characteristics between the three groups, except for the presence of silent ischaemia as clinical presentation (7.7 HMD vs. 2.2% POBA; P = 0.0001). No late stent thrombosis was found. At 18-month clinical follow-up patients treated with HMD, HTD and POBA presented a rate of MACE of 10.2, 0 and 8.7%, respectively (P = NS). Kaplan-Meier survival probability showed that HTD and POBA treatment tended to have more favourable outcomes at 18 months than the HMD treatment. CONCLUSION: In our registry, POBA seems to be as effective as other DES implantations in cases of DES ISR, especially in cases of focal type (Mehran classification IA, IC), in terms of long-term outcomes

Stroke Risk during TAVR: Is Prevention Better than Cure?

Periprocedural stroke is an uncommon but feared complication in patients undergoing transcatheter aortic valve replacement (TAVR). Typically embolic, it occurs more frequent in the first days (within seven days) after the procedure and it is secondary to procedural factors. It has a wide clinical spectrum and it is associated with increased mortality and a controversial worse impact on cognitive functions. Capture of the debris by different cerebral embolic protection devices (CEPDs) during the TAVR were thought to be a safe and effective preventive strategy to reduce the risk of stroke. A lot of trials were conducted to demonstrate a benefit of CEPDs, but the current evidence is not conclusive on their impact on periprocedural strokes

Smart mirror where I stand, who is the leanest in the sand?

Abstract. In this paper we introduce the Virtuoso project, which aims at creating a seamless interactive support for fitness and wellness activities in touristic resorts. The overall idea is to evaluate the current physical state of the user through a technology-enhanced mirror. We describe the state of the art technologies for building a smart mirror prototype. In addition, we compare different parameters for evaluating the user's physical state, considering the user's impact, the contact requirements and their cost. Finally we depict the planned setup and evaluation setting for the Virtuoso project

Mirror mirror on the wall... an unobtrusive intelligent multisensory mirror for well-being status self-assessment and visualization

A person’s well-being status is reflected by their face through a combination of facial expressions and physical signs. The SEMEOTICONS project translates the semeiotic code of the human face into measurements and computational descriptors that are automatically extracted from images, videos and 3D scans of the face. SEMEOTICONS developed a multisensory platform in the form of a smart mirror to identify signs related to cardio-metabolic risk. The aim was to enable users to self-monitor their well-being status over time and guide them to improve their lifestyle. Significant scientific and technological challenges have been addressed to build the multisensory mirror, from touchless data acquisition, to real-time processing and integration of multimodal data

Il trattamento interventistico percutaneo può risolvere la disfunzione erettile vasculogenica

Erectile dysfunction (ED) is defined as the inability to get and maintain a sufficient erection to ensure an acceptable sexual activity for the subject and the partner. Although ED does not represent per se a serious disease, it carries a notable and severe influence on quality of life, with significant implications on familiar and social relationship; DE may cause depression, shame, impairment of personal esteem and relational problems. Among many possible etiologies of ED, atherosclerotic disease of penile arteries represents one of the most frequent causes, so it should always be looked for in patients with multiple risk factors for cardiovascular disease or an established coronary or peripheral artery disease. Up to 75% of patients with ED have a stenosis of the iliac-pudendus-penile artery system, deputy to perfusion of male genital organ. Recently the potential treatment of this pathologic condition by percutaneous approach has emerged with valid angiographic results and with a significant improvement in symptoms and quality of life. This review focuses on the normal anatomy and physiology of erection, the pathophysiology of ED, the common points between ED and ischemic cardiomyopathy and, lastly, the new chance of endovascular intervention for ED, to give our cardiologist colleagues the opportunity to screen and adequately treat patients with vascular ED

Load network for microwave class F amplifier

In this paper we present the technique for development and calculation of the load network for the microwave class F power amplifier (PA) with addition of the third and the fifth voltage harmonics. The suggested load network compensates negative influence of parasitic elements of the transistor (of output capacitance and of output inductance) on the operation of class F PA. Also the load network allows one to decrease the negative influence of some real properties of the supply circuit shunt capacitor and the blocking capacitor on the impedances, which are created by the load network at the transistor chip. We have obtained the calculation formula for the transistor load resistance at the specified output power for class F PA with addition of the third and the fifth voltage harmonics