Stent Thrombogenicity Early in High Risk Interventional Settings is Driven by Stent Design and Deployment, and Protected by Polymer-Drug Coatings

Author Manuscript: 2012 April 5Background—Stent thrombosis is a lethal complication of endovascular intervention. Concern has been raised about the inherent risk associated with specific stent designs and drug-eluting coatings, yet clinical and animal support is equivocal. Methods and Results—We examined whether drug-eluting coatings are inherently thrombogenic and if the response to these materials was determined to a greater degree by stent design and deployment with custom-built stents. Drug/polymer coatings uniformly reduce rather than increase thrombogenicity relative to matched bare metal counterparts (0.65-fold; P=0.011). Thick-strutted (162 μm) stents were 1.5-fold more thrombogenic than otherwise identical thin-strutted (81 μm) devices in ex vivo flow loops (P<0.001), commensurate with 1.6-fold greater thrombus coverage 3 days after implantation in porcine coronary arteries (P=0.004). When bare metal stents were deployed in malapposed or overlapping configurations, thrombogenicity increased compared with apposed, length-matched controls (1.58-fold, P=0.001; and 2.32-fold, P<0.001). The thrombogenicity of polymer-coated stents with thin struts was lowest in all configurations and remained insensitive to incomplete deployment. Computational modeling–based predictions of stent-induced flow derangements correlated with spatial distribution of formed clots. Conclusions—Contrary to popular perception, drug/polymer coatings do not inherently increase acute stent clotting; they reduce thrombosis. However, strut dimensions and positioning relative to the vessel wall are critical factors in modulating stent thrombogenicity. Optimal stent geometries and surfaces, as demonstrated with thin stent struts, help reduce the potential for thrombosis despite complex stent configurations and variability in deployment

Feminist Theory, Feminist Psychology: A Bibliography Of Epistemology, Critical Analysis, And Applications

A selection of recent (post-1980) works on feminist theory and method, this bibliography includes literature from psychology and other social sciences, feminist studies, and philosophy of science. The first of its four sections concerns epistemology and metatheory. The second lists works that offer reformulations or critical analyses of key concepts in gender studies; many of these are grounded in social constructionist and feminist standpoint epistemologies. The third section cites writings that illustrate the potential of new epistemological stances or exemplify new ways of working. The last section lists related bibliographies. (232 entries.

BEAM TESTS OF THE ZEUS BARREL CALORIMETER

A fully compensating uranium-scintillator calorimeter was constructed for the ZEUS detector at HERA. Several of the barrel calorimeter modules were subjected to beam tests at Fermilab before shipping them to DESY for installation. The calibrations of the modules used beams of electrons and hadrons, measuring the uniformity of the response, and checking the resolution. The runs also provided opportunity to test a large fraction of the actual ZEUS calorimeter readout system in an integrated beam environment more than one year before HERA turn on. The experiment utilized two computer controlled mechanical structures. one of which was capable of holding up to four modules in order to study shower containment, and a magnetic spectrometer with a high resolution beam tracking system. During two running periods, beams of 6 to 110 GeV containing e, mu, pi, and pBAR were used. The results show energy resolutions of 35%/square-root E for hadrons and 19%/square-root E for electrons, uniformities at the 1% level, energy nonlinearity less than 1%, and equal response for electrons and hadrons