Koronare Stent-Thrombosen: Was gibt es Neues für 2011?

Zusammenfassung: Stent-Thrombosen (ST) stellen eine schwerwiegende Komplikation der perkutanen Behandlung der koronaren Herzkrankheit dar und sind mit einer hohen Sterblichkeitsrate von bis zu 45% verbunden. Bare-Metal-Stents (BMS) und Drug-Eluting-Stents (DES) haben eine ähnliche Inzidenz für frühe (0,6-1,2%) und späte (0,3-0,4%) ST. Sehr späte ST (über 1Jahr nach Stent-Implantation) weisen einen unabhängigen pathogenetischen Mechanismus auf und werden fast ausschließlich nach der Implantation von DES der 1. Generation mit einer Rate von 0,6% Ereignissen/Jahr beobachtet. Starke Determinanten für das Auftreten früher und später ST sind eine unzureichende Thrombozytenaggregationshemmertherapie, ein akutes Koronarsyndrom, Auftreten von Komplikationen während des Eingriffs, das unmittelbare postprozedurale Resultat sowie Begleiterkrankungen des Patienten. Sehr späte ST haben eine eigenständige Pathogenese - eine direkt medikamentös bedingte Hemmung der Reendothelialisierung und eine durch das Medikament oder das Polymer des Stent verursachte chronische Entzündung der Gefäßwand mit in der Folge gestörter Reendothelialisierung, welche zu einem positivem Remodelling der Arterienwand mit sekundärer Malapposition des Stent führt. In der Prävention der ST spielt die duale Thrombozytenaggregationshemmertherapie eine zentrale Rolle. Das vorzeitige Absetzen dieser Therapie in den ersten 6Monaten nach Stent-Implantation führt zu einer erhöhten Inzidenz von ST. Zur Prävention gehört auch der Fortschritt. Erfreulicherweise haben die Verwendung von DES der 2. Generation und neue Thrombozytenaggregationshemmertherapien die Inzidenz der ST signifikant verringer

Radio Occultation Data Analysis With Analytical Ray-Tracing

Radio occultation experiments are a sensing technique dedicated to the remote sounding of planetary atmospheres. The technique exploits the frequency shift of a radio signal due to refraction in a planetary atmosphere. The aim is to infer the physical properties of the neutral atmosphere (e.g., pressure and temperature) and ionosphere (e.g., the electron number density). For one-way occultations, the data processing usually relies on Abel transform algorithms when the atmosphere is spherically symmetric. For two-way occultations, such techniques require the introduction of approximate relationships for the bending experienced by the signal to be obtained. In this context, we introduce a new method to process two-way occultations data by spherically symmetric atmospheres using a ray-tracing approach. However, the numerical integration of the geometrical optics equation through the atmosphere requires a significant computational time due to initial pointing issues. For this reason, our novel algorithm exploits a closed-form solution to the equations of geometrical optics (Bourgoin et al., A&A, 624, A41, 2019, https://doi.org/10.1051/0004-6361/201834962) applied to a spherically symmetric atmosphere. Within this approach, the bending is directly provided by the analytical solution and no numerical integration is required. In addition, we develop a procedure enabling us to disentangle the contributions from dispersive and neutral media in the frequency shift. This procedure is validated by comparing our vertical profiles to those obtained using Abel inversion or numerical ray-tracing for Mars and Titan occultation experiments. We show that our algorithm provides similar results to purely numerical ray-tracing algorithms while significantly decreasing the computational time

[(1R)-3-Benzoyl-1,7,7-trimethyl­bicyclo­[2.2.1]heptan-2-onato-κ2 O,O′]chlorido(η6-p-cymene)ruthenium(II)

The asymmetric unit of the title compound, [RuCl(C10H14)(C17H19O2)], contains two diastereomers. In both, the RuII ion has a tetra­hedral coordination, formed by two O atoms of the camphor-derived ligand and the p-cymene and Cl ligands. In the crystal structure, weak inter­molecular C—H⋯Cl inter­actions link the mol­ecules into columns propagated along [010]

Percutaneous coronary interventions in Europe 1992-2001

Aims The purpose of this registry is to collect data on trends in interventional cardiology within Europe. Special interest focuses on relative increases and ratios in newer re-vascularisation approaches and its distribution in different regions in Europe. We report the data of the year 2001 and give an overview of the development of coronary interventions since 1992, when the first data collection was performed. Methods and Results Questionnaires were distributed to delegates of the individual national societies of cardiology represented in the European Society of Cardiology. These were completed by the local institutions and operators and showed that 1,806,238 angiograms and 617,176 percutaneous transluminal coronary angioplasties (PTCAs) were performed in 2001. This is an increase of 10% and 17%, respectively, compared with the year 2000. The population-adjusted PTCA rate rose from nearly 800 procedures per 106 inhabitants in the year 2000 to approximately 990 procedures per 106 inhabitants in 2001. Coronary stenting increased by 25% to about 488,900 stents implanted in 2001. Complication rates remained unchanged, and the need for emergency coronary artery bypass grafting is still at 0.2% per percutaneous intervention. Conclusion Interventional cardiology in Europe is still expanding, mainly due to rapid growth in countries with lower socio-economical levels. Most central European countries reported only minor increases in procedures performed. Coronary stenting remains the only noteworthy adjunctive strategy to balloon angioplast