Invasive imaging of bioresorbable coronary scaffolds - A review

Various fully bioresorbable stents (BRS) have been recently developed, allowing for temporary scaffolding of the vessel wall. The potentially unique advantage of BRS to temporary scaffold the vessel could reduce the risk of adverse clinical outcomes caused by acute vessel geometry changes, late malapposition, jailed side branches or inflexibility of permanent stents. The design of BRS is, however, not similar for all stents, resulting in differences in degradation and behaviour. To assess the performance of BRS, the effect of degradation and behaviour on the vessel wall should be accurately evaluated. Intracoronary imaging techniques such as intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) allow for detailed longitudinal evaluation of the stent and the vessel wall and might therefore aid in improving design and behaviour of BRS

Percutaneous placement and removal of large diameter femoral artery sheaths with the prostar XL device

INTRODUCTION For successful transcatheter aortic valve implantation (TAVI) as well as endovascular abdominal aneurysm repair (EVAR), and thoracic endovascular aneurysm repair (TEVAR), the insertion of large diameter arterial sheaths is necessary. Because of the necessary caliber of the sheaths, usually between 18 and 24 F (6-8 mm), the access is almost exclusively chosen via the femoraliliac arteries. In the past years we gradually changed our technique from a surgical cut-down to a percutaneous technique in all patients. The advantages of this less invasive technique are increased patient comfort immediately after the procedure and a diminished requirement for anesthetic drugs during and after the procedure. In most patients, the percutaneous technique of placement and removal of large diameter femoral arterial sheaths can be performed under local anesthesia only. In other words, the need for the presence of an anesthesiological team is dictated by the condition of the patient only and, to some extent, to the length of the procedure and not by the necessity to perform an open-surgical cut-down in the groin