Woudstra, P.

English

Coronary artery disease is a pathophysiological process that affects a large number of patients and remains one of the leading causes of mortality up until day. In this thesis we did investigate the natural course of atherosclerosis in a pathophysiology study focusing on possible mechanism. A better understanding of this process and further risk stratification could be of great importance in improvement of outcomes.The outcomes of patients with coronary artery disease have been greatly improved by the introduction of coronary stents. However, the first generation coronary stents are hampered by clinical important complication such as restenosis and stent thrombosis. The main focus of the novel stent technologies described in the second part of this thesis is to improve vascular healing to overcome these limitations. The novel stents have an endothelial progenitor cells attracting layer both solely (Genous stent) and in combination with a intima hyperplasia reducing drug attached (COMBO stent). In international multi-centre randomized trials and registries we collected data on clinical outcomes in patients treated with these stents for coronary artery disease. The first results of the COMBO stent in an all-comer population shows favourable outcomes with low event rates.The results described in this thesis could lead to the introduction of novel safer stent techniques. In combination with a better understanding of the pathophysiology by future research this should lead to better outcomes in patients with coronary artery disease

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UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl)UvA-DARE (Digital Academic Repository)Coronary artery disease and new stent technologyWoudstra, P.Publication date2019Document VersionOther versionLicenseOtherLink to publicationCitation for published version (APA):Woudstra, P. (2019). Coronary artery disease and new stent technology. [Thesis, fullyinternal, Universiteit van Amsterdam].General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s)and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an opencontent license (like Creative Commons).Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, pleaselet the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the materialinaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letterto: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. Youwill be contacted as soon as possible.Download date:09 Mar 2023Coronary Artery Disease and New Stent TechnologyPier WoudstraCoronary artery Disease anD new stent teChnologyPier WoudstraCoronary artery Disease anD new stent teChnologyPier WoudstraCoronary Artery Disease and New Stent TechnologyPier WoudstraCover photo: Tunnel Noord-Zuidlijn Amsterdam, Stefan Witte fotografie (www.stefanwitte.nl)Layout design: Optima Grafische Communicatie (www.ogc.nl)ISBN: 978-94-6361-320-0The author received an unrestricted educational grant from OrbusNeich Medical Holding BV for the publication of this thesis.Additional financial support for publication of this thesis was kindly provided by: Academic Medical Center – Amsterdam UMC – University of Amsterdam, ACIST Europe BV, Angiocare BV, Bayer BV, Beems Oogartsenpraktijk BV, Boehringer-Ingelheim BV, Cardialysis, Chipsoft, Guerbet, Medis Medical Imaging Systems BV, Microport BV, Novartis Pharma BV, Pie Medical Imaging BV, Servier Nederland Farma BV, ZOLL Medical.© 2019 Pier Woudstra, Amsterdam, The Netherlands.All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission from the author.Coronary Artery Disease and New Stent TechnologyACADEMISCH PROEFSCHRIFTter verkrijging van de graad van doctoraan de Universiteit van Amsterdamop gezag van de Rector Magnificusprof. dr. ir. K.I.J. Maexten overstaan van een door het College voor Promoties ingestelde commissie,in het openbaar te verdedigen in de Agnietenkapelop donderdag 24 oktober 2019, te 10.00 uurdoor Pier Woudstrageboren te LeeuwarderadeelPROMOTIECOMMISSIEPromotor:  Prof. dr. R.J. de Winter AMC-UVACopromotores: Dr. P. Damman  Radboud Universiteit Nijmegen Dr. M.A.M. Beijk  AMC-UVAOverige leden:  Prof. Dr. Med. M. Joner Deutsches Herzzentrum München Prof. Dr. J.W. Jukema Universiteit Leiden Prof. Dr. R.J.G. Peters AMC-UVA Prof. Dr. N. van Royen Radboud Universiteit Nijmegen Prof. Dr. C.J.M. de Vries AMC-UVA Prof. Dr. A.C. van der Wal AMC-UVA Dr. J.J. Wykrzykowska AMC-UVAFaculteit der GeneeskundeFinancial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged.TAblE Of CONTENTSIntroduction and outlineChapter 1 9Adapted from: Next-generation DES: the COMBO dual therapy stent with Genous endothelial progenitor capturing technology and an abluminal sirolimus matrix. Expert Rev Med Devices. 2014 Mar;11(2):121-35.Part A: PATHOPHYSIOlOGY, PROGNOSTICATION AND RISK STRATIfICATIONChapter 2 21Natural Progression of Atherosclerosis from Pathologic Intimal Thickening to Late Fibroatheroma in Human Coronary Arteries: A Pathology Study. Atherosclerosis. 2015 Aug;241(2):772-82.Chapter 3 45Admission Lipoprotein-associated Phospholipase A2 Activity is Not Associated with Long-term Clinical Outcomes after ST-segment Elevation Myocardial Infarction. PLoS One. 2014 May 1;9(5):e96251.Chapter 4 67Prognostic relevance of PCI-related myocardial infarction. Nat Rev Cardiol. 2013 Apr;10(4):231-6.Part b: STENT TECHNOlOGYChapter 5 85Clinical Outcomes after Bare Metal Stenting in Diabetic Patients with Lesions Carrying a Low Risk of Restenosis. Catheter Cardiovasc Interv. 2013 Jan 1;81(1):26-33.Chapter 6 101Five-year follow-up of the endothelial progenitor cell capturing stent versus the paxlitaxel-eluting stent in de novo coronary lesions with a high risk of coronary restenosis. Catheter Cardiovasc Interv. 2018 Jun;91(7):1212-1218.Chapter 7 119Final 5-Year Outcomes of the TRIAS High Risk of Restenosis Study; a Multi-Center, Randomized Trial Comparing Endothelial Progenitor Cell Capturing Stents with Drug-Eluting Stents. [submitted]Chapter 8 1351-Year Results of the REMEDEE Registry: Clinical Outcomes After Deployment of the Abluminal Sirolimus-Coated Bioengineered (Combo) Stent in a Multicenter, Prospective All-Comers Registry. JACC Cardiovasc Interv. 2016 Jun 13;9(11):1127-34.Chapter 9 149One year clinical outcomes in patients with insulin-treated diabetes mellitus and non-insulin-treated diabetes mellitus compared to non-diabetics after deployment of the bio-engineered COMBO stent. Int J Cardiol. 2017 Jan 1;226:60-64.Chapter 10 163Evaluation of clinical outcomes after COMBO stent treatment in patients presenting with acute coronary syndrome. Catheter Cardiovasc Interv. 2017 Aug 1;90(2):E31-E37.Chapter 11 179Amsterdam Investigator-initiateD Absorb strategy all-comers trial (AIDA trial): a clinical evaluation comparing the efficacy and performance of ABSORB everolimus-eluting bioresorbable vascular scaffold strategy vs the XIENCE family (XIENCE PRIME or XIENCE Xpedition) everolimus-eluting coronary stent strategy in the treatment of coronary lesions in consecutive all-comers: rationale and study design. Am Heart J. 2014 Feb;167(2):133-40.Summary and future perspectiveChapter 12 195Summary and future perspectiveSamenvatting en toekomstpersepctief 202Appendices 209PhD Portfolio 211Contributing authors 213List of publications 215Dankwoord 221Curriculum Vitae 225

Coronary artery disease and new stent technology

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Coronary artery disease and new stent technology

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