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Bare metal stent vs drug eluting stent anticoagulation

Drug-Eluting versus Bare-Metal Stents in Large Coronary

ABSTRACT: Complications seen with percutaneous coronary intervention led to the development of bare metal stents and, later, drug-eluting stents. To prevent progressive atherosclerosis in the case of drug-eluting stents, current guidelines suggest a course of dual antiplatelet therapy for 12 months However, in some countries and regions bare metal stents (BMS) are still utilized. Irrespective of stent type, stent thrombosis is an uncommon but serious complication of coronary artery stenting that often presents as death and is almost always accompanied by myocardial infarction (MI), usually with ST-segment elevation Percutaneous Coronary Intervention and Warfarin Treatment. Oral anticoagulation was routinely used for coronary stent thrombosis prevention during the first era of stents. 1 It has since been replaced by the combination of aspirin and a thienopyridine because studies have shown a definite advantage of the antiplatelet combination on coronary events 2-4 and on reducing the risk of access-site. In treating coronary artery disease, many factors influence the choice of bare metal stent (BMS) or drug-eluting stent (DES), including bleed risk and suitability for prolonged dual antiplatelet therapy. Atrial fibrillation (AF) further complicates this choice, due to common use of anticoagulation

Antiplatelet Therapy Duration Following Bare Metal or Drug

• First-generation drug-eluting stents, including sirolimus- and paclitaxel-eluting stents, have resulted in similar rates of mortality and myocardial infarction as bare metal stents in a broad spectrum of patients and lesions; however, concern over an increased rate of late stent thrombosis has led to reliance on extended dual antiplatelet therapy Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis. Eur Heart J 2006; 27:2784. Stone GW, Ellis SG, Colombo A, et al. Offsetting impact of thrombosis and restenosis on the occurrence of death and myocardial infarction after paclitaxel-eluting and bare metal stent.

Drug-Eluting or Bare-Metal Stents for Coronary Artery

A stent is a small mesh tube inserted into an artery to keep it open. A drug-eluting stent is coated with a slow-release medication to help prevent blood clots from forming in a stent. Blood clotting in a stent can cause a future blockage (restenosis) and may lead to a heart attack. Stents without a drug coating are called bare-metal stents Multiple randomized trials have shown that drug-eluting stents provide better long-term outcomes than bare-metal stents in the following populations: patients with diabetes,9 long and/or complex. There were no significant differences in crude mortality (Table3) in the drug-eluting stent than in the bare-metal stent cohort eras: 1.4% vs 1.4% at 3 months, 2.5% vs 2.5% at 6 months, 4.3% vs 4.5% at 12 months, and 8.4% vs 8.4% at 24 months of follow-up The largest contemporary randomized controlled trial comparing drug-eluting vs bare-metal stents showed no advantage of drug-eluting over bare-metal stents in terms of all-cause of mortality. 5 Similarly, in the most recent and comprehensive meta-analysis of randomized trials comparing new-generation drug-eluting with bare-metal stents, Piccolo. Two types of stents are available for use, a stent that is coated with a drug intended to reduce the risk of future blockages (drug-eluting stent) and an uncoated stent (bare-metal stent). In this review, we aimed to assess the benefits and harms of drug-eluting stents compared with bare-metal stents

An update on drug-eluting stents versus bare-metal stents

  1. Introduction. Drug-eluting stents revolutionized the treatment of symptomatic coronary artery disease due to less restenosis compared with bare metal stents. 1 However, stents require dual antiplatelet therapy with aspirin and thienopyridines (eg, clopidogrel) after stent deployment to prevent stent thrombosis, which often presents as sudden death or a myocardial infarction
  2. The FDA has approved multiple drug-eluting stents for PCI, which are now referred to by the ACC/AHA in most of the PCI and STEMI guidelines. First-generation DESs include Cypher, a sirolimus-eluting stent, and Taxus, a paclitaxel-eluting stent. Second-generation DESs that are approved by the FDA include the Xience/Promus, or everolimus- eluting.
  3. Patients who receive drug-eluting stents (DES) require a regimen of dual antiplatelet therapy (DAPT) consisting of aspirin and an adenosine diphosphate (ADP) receptor antagonist. 1 This therapy has been proven superior to anticoagulation therapy in terms of periprocedural ischemic and bleeding complications. 2 While aspirin is usually prescribed for life, the optimal duration of ADP-receptor.

As stent technology continues to improve and antiplatelet regimens become more tailored, BMS will still serve an important role in PCI. References. Steinberg DH, Mishra S, Javaid A, et al. Comparison of effectiveness of bare metal stents versus drug-eluting stents in large (> or =3.5 mm) coronary arteries. Am J Cardiol 2007;99:599-602 Predictors and variability of drug-eluting vs bare-metal stent selection in contemporary percutaneous coronary intervention: Insights from the PRISM study. Shafiq A(1), Gosch K(2), Amin AP(3), Ting HH(4), Spertus JA(2)(5), Salisbury AC(2)(5). Author information: (1)Department of Cardiology, Aurora Health Care, Milwaukee, Wisconsin Percutaneous coronary intervention (PCI) involves both nonstent and stent procedures. While bare-metal stents (BMS) are still utilized, drug-eluting stents (DES) now offer clinicians the ability to prevent restenosis via a different mechanism

Use drug-eluting stents only if they have significant net advantage over bare-metal stents. Minimize the duration of triple therapy. Target international normalized ratio to the low therapeutic. Approximately 5% of patients referred for coronary stenting are on long-term oral anticoagulation. Use of drug-eluting stents in this patient group varies from 2 to 100% according to local. In this period of heightened concern over the increased risk of late and very late stent thrombosis with the use of drug-eluting stents, it is worthwhile to examine the anticoagulation regimens given after insertion of a stent. The development of coronary stents has encouraged more widespread use of angioplasty by effectively reducing the acute.

Drug-eluting or bare-metal stents? Nature Reviews Cardiolog

DAPT is currently recommended for at least one month after intervention, irrespective of the stent type (bare metal vs. drug-eluting) [3]. Stenting below-the-knee arteries is often followed by a longer period of DAPT, but no specific evidence is available [3] Bare-metal stents or second-generation drug-eluting stents are recommended for patients receiving anticoagulation agents. DAPT for longer than 1 month places the patients at a high risk of bleeding. A bare-metal stent is preferred if the risk of restenosis is lower. Previous

Background. Drug-eluting stents (DES) reduce stent restenosis compared with bare-metal stents (BMS). However, their use in patients requiring long-term oral anticoagulation (OAC) is controversial owing to increased risk of bleeding associated with OAC plus antiplatelet treatment over time indication for long-term oral anticoagulation (OAC) because of atrial fibrillation (AF). 1,2 Although the use of drug-eluting stents (DES) has decreased the rate of restenosis in many patient populations when compared with bare-metal stents (BMS),3-5 little is known about their performance in patients with AF undergoing PCI Since their approval in the United States for the treatment of stenotic coronary artery lesions in 2003, drug-eluting stents (DES) have largely supplanted bare metal stents (BMS) in percutaneous coronary intervention (PCI) procedures. 6 The major advantage of DES over BMS is a reduction in the development of in-stent stenosis and as a. Request PDF | Safety of drug-eluting stents compared to bare metal stents in patients with an indication for long-term oral anticoagulation: A propensity score matched analysis | Background: Drug.

A total of 425 patients (36%) received a bare-metal stent and 769 patients (64%) received a drug-eluting stent. A history of previous PCI, current non-ST-elevation myocardial infarction, anterior descending artery as the infarct-related artery and being initially admitted to a hospital with a catheterization laboratory were associated with drug. BACKGROUND: Drug-eluting stents (DES) reduce stent restenosis compared with bare-metal stents (BMS). However, their use in patients requiring long-term oral anticoagulation (OAC) is controversial owing to increased risk of bleeding associated with OAC plus antiplatelet treatment over time. OBJECTIVE: To assess the safety of DES vs BMS in patients requiring long-term OAC for any reason The problem is that many of these reactions aren't predictable prior to stent implantation. So patients who cannot tolerate the required antiplatelet therapy, etc. wind up with a drug-eluting stent. Of course, bare metal stents also require antiplatelet therapy, but only for 4-6 weeks, not 6-12 months The dramatic reduction in in-stent restenosis (ISR) afforded by drug-eluting stents (DES) led to their widespread use throughout the world. Subsequently, more patients and lesions could be treated percutaneously with less thought about ISR. With the advent of a more widespread adoption of percutaneous coronary intervention, registry data began suggesting an increased risk of late and very late.

ACC/AHA Guideline Update on Duration of Dual Antiplatelet

  1. Drug-eluting stents (DES) were positioned in 71 (55.9%), and bare-metal stents (BMS) were positioned in 56 (44.1%) patients. Atrial fibrillation (AF) was the main indication (59.1%) for AC treatment. The mean triple therapy duration was 5.6 +/- 4.6 months, and clinical follow-up was 21.0 +/- 19.8 months
  2. Drug-eluting stents have only been available since 2003. Because no long-term studies have been conducted, the length of anticoagulation remains unclear. Close more info about ANTICOAGULATION.
  3. Background Acute myocardial infarction (AMI) complicates the clinical management of atrial fibrillation (AF) because coronary stenting may influence subsequent antithrombotic therapy. We investigated the use of a bare-metal stent (BMS) or a drug-eluting stent (DES) and associated outcomes in patients with pre-existing AF and first AMI undergoing percutaneous coronary intervention
  4. Percutaneous coronary intervention with implantation of drug-eluting stents (DES) has reduced the need for repeat revascularisation compared with bare-metal stents (BMS). 1 However, first-generation DES with durable polymers were associated with a slightly increased risk of stent thrombosis, especially very late stent thrombosis after.
  5. Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). anticipated surgery, use of warfarin, lower hemoglobin, prior history of bleeding, and treatment of right coronary and left circumflex artery.

Brilakis ES, Edson R, Bhatt DL, et al. Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial. Lancet 2018;391:1997-2007. Editorial Comment: Jeger RV, Möbius-Winkler S. Stents in saphenous vein grafts. Lancet 2018;391:1967-8 Long-term Clinical Outcomes Following Drug-Eluting or Bare-Metal Stent Placement in Patients With Severely Reduced GFR: Results of the Massachusetts Data Analysis Center (Mass-DAC) State Registry. By Manu Varma. Angiographic and clinical outcomes of drug-eluting versus bare metal stent deployment in the Occluded Artery Trial Age under 45 or over 80, anemia and previous anticoagulation and/or atrial fibrillation were associated with bare-metal stent use. Conclusions Approximately two-thirds of patients received drug-eluting stents, which were less frequently implanted in patients with ST-elevation myocardial infarction, aged over 80 years, female, with a previous.

  1. At 6 years of follow-up, the rate of the primary composite outcome of death from any cause and nonfatal spontaneous myocardial infarction did not differ between the drug-eluting stent group and the bare-metal stent group (16.6% vs. 17.1%, P=0.66)
  2. In early studies of patients who received bare metal stents (BMS), the rate of stent thrombosis was significantly lower with aspirin plus ticlopidine than with aspirin alone (or aspirin plus warfarin) STARS trial - 1653 patients were randomly assigned to aspirin alone or in combination with warfarin or ticlopidine
  3. K antagonist (VKA: 36.4% vs. 35.5%), bridging with low-molecular weight heparin (30.0% vs.
  4. Revista Portuguesa de Cardiologia (2015-07-01) . Use of drug-eluting versus bare-metal stents after an acute coronary syndrome in Portugal: The EURHOBOP stud
  5. Patients with drug-eluting stent- (DES) related in-stent restenosis (ISR) were found to have poorer long-term outcomes than patients with bare-metal stent- (BMS) related ISR, according to results of a meta-analysis published in the Journal of Interventional Cardiology.. Research databases were searched for studies in which clinical outcomes were compared for DES-related ISR (DES-ISR) vs BMS.
  6. Drug-eluting stents better than bare-metal stents for heart attack patients this is the largest study to focus on the appropriate use of anticoagulation medications and drug-eluting stents in.
  7. Safety of drug-eluting stents compared to bare metal stents in patients with an indication for long-term oral anticoagulation: A propensity score matched analysis. Javier Limeres, Gregory Y H Lip, Bruno García Del Blanco, Ignacio Ferreira-González, Maria Mutuberria,.

Background While a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared with bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial. Methods A search strategy using the terms 'stents', 'drug-eluting stents. For patients receiving bare metal stents (32% of patients), clopidogrel was continued for at least one month and up to one year. For patients who received drug-eluting stents (65% of patients), clopidogrel was to be administered for at least one year. The authors do not state which anticoagulants were given in the study Drug-eluting stents more effective than bare-metal stents in heart attack patients May 26, 2009 Findings released from 1 of the largest percutaneous coronary intervention trials eve

Video: Dual Antiplatelet Therapy Duration in Patients With Drug

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  1. Use of drug-eluting vs. bare-metal stents after an acute coronary syndrome in Portugal: The EURHOBOP study anemia and previous anticoagulation and/or atrial fibrillation were associated with.
  2. Rates of revascularization procedures were low in each group: 16.5% in the drug-eluting stent group vs 19.8% in the bare-metal stent group. Patients who received a drug-eluting stent did have less need for a second revascularization procedure, but not to the level surgeons might have expected, Dr Bonaa said
  3. Moreover, the effect of the drug can be reversed by platelet transfusions in case of active bleeding. Routine anticoagulant therapy is not indicated after primary PCI [3]. Bare metal stents (BMS) are preferable to drug-eluting stents (DES) in patients at risk for bleeding, unless the latter are absolutely indicated [1]
  4. When angioplasty is combined with drug-eluting stent placement, there's a small risk the treated artery may become clogged again (less than 5%). The risk of re-narrowing of the artery is about 10% to 20% when bare-metal stents are used. Blood clots. Blood clots can form within stents even after the procedure
  5. If stent implantation was for non ST elevation acute coronary syndrome then combination therapy is beneficial for at least one year. 4 If implantation was elective the duration of clopidogrel therapy depends on the stent type. Non-drug-eluting stents. Bare metal stents require a shorter duration of combination therapy than drug-eluting stents
  6. In addition, the XIENCE Sierra™ stent system is indicated for treating de novo chronic total coronary occlusions. CONTRAINDICATIONS. The XIENCE Sierra™ stent system is contraindicated for use in: Patients who cannot tolerate, including allergy or hypersensitivity to, procedural anticoagulation or the post-procedural antiplatelet regimen
  7. Dual antiplatelet therapy (DAPT), defined as the use of a P2Y12 receptor inhibitor (clopidogrel, ticagrelor or prasugrel) and aspirin, is required after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 1 Although the use of DES has been shown to reduce the rate of restenosis as compared with bare-metal stents (BMS), there is concern that DES may be associated with a.

But research has shown drug-eluting stents carry a higher risk of blood clots at the stent site than bare metal stents do. If you receive an eluting stent, you may need to take an anticoagulant medication (blood thinner) over a long period of time to reduce your risk of a clot All lesions requiring intervention in one or more native coronary artery/coronary artery by-pass graft are amendable for implantation of drug-eluting stents only, or bare-metal stents only. The patient has a unique 11-digit Norwegian person number, is able to communicate in Norwegian, and is expected not to emigrate during study follow-up 1 INTRODUCTION. Although so‐called second‐generation drug‐eluting stents (G2‐DES) have been developed to overcome residual safety concerns from first‐generation drug‐eluting stent (DES), 1-4 delayed reendothelialization is still considered to be an inevitable safety matter in any type of DES. 5-10 In particular, the safety of DES in acute and subacute phases in cases of ST. This week's topics include studies on the benefits of drug-eluting vs. bare-metal stents, using walking speed and blood pressure measurements to predict mortality in the elderly, stroke and bleeding in AF with chronic kidney disease, and the diagnosis and management of peripheral artery disease

Coronary Stents and Chronic Anticoagulation Circulatio

BMS, bare metal stents; DES, drug-eluting stents; DAPT, dual antiplatelet therapy. Large vessel diameter The Basel Stent Kosten Effektivitäts Trial-Prospective Validation Examination (BASKET-PROVE) trial randomized DES and BMS in patients with large vessels (>3 mm) However, there are no randomized controlled studies comparing 6 vs. 12 months of DAPT with newer drug-eluting stents following STEMI. Newer drug-eluting stents are made of biocompatible polymers with thinner struts and are thought to be fully absorbed by 3 months. International guidelines still recommend 12 months of DAPT following drug-eluting. Drug-eluting stents Bleeding ABSTRACT Background: Drug-eluting stents (DES) reduce stent restenosis compared with bare-metal stents (BMS). However, their use in patients requiring long-term oral anticoagulation (OAC) is controversial owing to increased risk of bleeding associated with OAC plus antiplatelet treatment over time Approximately 5-8% of patients undergoing percutaneous coronary intervention (PCI) and stenting have an indication for long-term oral anticoagulation (OAC) because of atrial fibrillation (AF). 1, 2 Although the use of drug-eluting stents (DES) has decreased the rate of restenosis in many patient populations when compared with bare-metal stents (BMS), 3 - 5 little is known about their.

Atrial Fibrillation and Stent Selection (Bare Metal vs

Drug-eluting stents were then introduced principally to overcome the problem of late restenosis that was still occurring at an excessively high rate with bare-metal stents. Today, stents (both drug-eluting and bare-metal) are the dominant revascularization modality for the treatment of most patients with obstructive coronary artery disease Safety of drug-eluting stents compared to bare metal stents in patients with an indication for long-term oral anticoagulation: A propensity score matched analysis. Javier Limeres, Gregory Y.H. Lip, Bruno García del Blanco,. Drug‐eluting stents (DES) reduce risk of in‐stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare‐metal stents (BMS)

by Carolyn Thomas ♥ @HeartSisters Remember last month when I covered the topic of stretch pain in heart patients who have had a coronary stent implanted?. To recap, temporary post-stent stretch pain in the chest is due to the dilation of an artery when a metal stent is being implanted inside that artery, and it typically occurs in about 40 per cent of stent patients. 1 A number of you. In a 2015 trial comparing a biolimus A9-coated stent vs a bare-metal stent, patients received DAPT for 1 month after stent placement. The drug-coated stent was found to be superior in terms of the primary safety end point (cardiac death, myocardial infarction, or stent thrombosis). 12 This stent is not yet approved by the US Food and Drug. Also, the safety profile of the drug-eluting stent was similar or even better than that of the bare metal stent: the composite of cardiac death, myocardial infarction, or stent thrombosis was 9.4% in the drug-eluting stent group and 12.9% in the bare metal stent group (p<0.001 for noninferiority)

Bare Metal and Drug-Eluting Coronary Stents Thoracic Ke

  1. Objective To evaluate the efficacy and safety of standard term (12 months) or long term (>12 months) dual antiplatelet therapy (DAPT) versus short term (<6 months) DAPT after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). Design Systematic review and network meta-analysis. Data sources Relevant studies published between June 1983 and April 2018 from Medline, Embase.
  2. ated, the prospect of in-stent thrombosis is an incessant danger-so, there is some trade-off
  3. PERCUTANEOUS coronary intervention (PCI) with stenting1is the most common method of myocardial revascularization. Coronary stents have been shown to provide better short- and long-term outcome when compared with balloon angioplasty alone.2Both bare-metal stents (BMSs) and drug-eluting stents are used in clinical practice, the former for more than 10 yr, whereas drug-eluting stents have been.
  4. Chen DY, Mao CT, Tsai ML, Hsieh MJ, Lin YS, Cherng WJ, et al. Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis—A Nationwide Cohort Study. Circ J. 2016; 80:363-70. 10.1253/circj.CJ-15-0778 [Google Scholar

SYNOPSIS: This randomized trial showed no difference between contemporary drug-eluting stents and bare-metal stents with regard to death and myocardial infarction, while drug-eluting stents demonstrated an advantage in both repeat revascularization and stent thrombosis at six years of follow-up First-generation drug-eluting stents (DES) reduced restenosis and the need for reinterventions compared to bare-metal stents (BMS)1, 2. However, the higher incidence rates of late thrombosis 3 , mortality and infarction 4 ueled controversy over the implementation of these devices in patients with STEMI, a population with an identified increased. Drug-eluting coronary stents (DES) have reduced rates of restenosis and repeat revascularization compared with bare-metal stents (BMS), but first-generation DES were associated with higher rates of stent thrombosis than BMS — particularly beyond the first few months after implantation Neither bare metal (except for an outdated model) nor drug-eluting stents are FDA approved for use in SVGs. The purpose of CSP#571 is to compare the outcomes after DES vs. BMS use in SVGs. In CSP#571 patients who need stenting of SVG blockages will be randomized to receive DES or BMS in a 1:1 ratio bare-metal stents (BMS) in patients with STEMI (1). Although drug-eluting stents (DES) have been used widely in unstable angina and in acute myocardial infarction (MI), their routine use in STEMI is still a point of debate (1,3). Randomized clinical trials and meta-analyses have shown that DES in STEMI and in stable patients reduce the rate

Clinical use of intracoronary bare metal stents - UpToDat

This interview with Emmanouil Brilakis from Minneapolis Heart Institute, Minneapolis, US discusses Drug-Eluting Stents vs. Bare Metal Stents In Saphenous Vein Graft Angioplasty (DIVA). Filmed by Radcliffe Cardiology on-site at ESC 2017 Recognizing that in-stent restenosis was the result of neointimal hyperplasia, research focused on means to prevent it. These efforts culminated in the current generation of devices which have now become predicate devices - namely, drug-eluting stents. Current drug-eluting stents have three components: The bare metal backbone, which serves as. Drug-Eluting vs. Bare-Metal Stents, Using Instrumental Variable Analysis David Cohen, MD MSc David J. Cohen, the principal investigator of an observational PCI registry study of drug-eluting versus bare-metal stents, sheds light on a risk-adjustment technique called instrumental variable analysis Drug-eluting stents (DES) 7.2 vs 3.1, P = 0.02; bare-metal stents (BMS) 6.0 vs 5.5, P = 0.70 (Reprinted from Eisenstein EL, Anstrom KJ, Kong DF, Shaw LK, Tuttle RH, Mark DB, Kramer JM, Harrington RA, Matchar DB, Kandzari DE, Peterson ED, Schulman KA, Califf RM. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation (online 2006) Drug eluting stents vs. bare metal stents in Sweden: the results of the SCAAR trial. [www.clinicaltrialresults.org] (accessed 14 February 2008) 49. Marzocchi A et al. (2007) Long.

Antithrombotic management in patients with atrialExample of the halo effect

Drug-eluting stents: Do they increase heart attack risk

The ZEUS, SENIOR and LEADERS FREE trials all changed perspectives on the use of bare-metal stents for patients with high bleeding risk, showing that the use of drug-eluting stents with 1 month of DAPT was superior in terms of safety and efficacy over the use of bare-metal stents with 1 month of DAPT. 33,34,40 The LEADERS FREE trial randomised. Prospective multicenter controlled randomized trial to compare the safety and efficacy of drug eluting vs. bare metal stents in percutaneous coronary interventions of saphenous vein grafts. Hypothesis: Survival and outcome will be significantly better in patients receiving DES than in patients receiving BMS regarding both short-term and long.

Drug-Eluting Coronary Artery Stents - American Family

Outcomes Following Coronary Stenting in the Era of Bare

While previous studies of drug-eluting stents have often focused on their use in patients with stable or unstable chest pain, this is the largest study to focus on the appropriate use of anticoagulation medications and drug-eluting stents in patients experiencing the most dangerous form of heart attack (ST-elevation myocardial infarction) Bare metal stent (BMS) implantation has been recognized as a class I indication in the treatment of acute ST-segment elevation myocardial infarction (STEMI) [].Recently, the long-term efficacy of first-generation drug-eluting stent (1st DES) for primary percutaneous coronary intervention (PCI) has been proven in several pivotal randomized controlled trials [2, 3]. 1st DES is superior to BMS as.

An original stent made of metals or metal alloys was called a bare-metal stent (BMS). They ruled the roost for more than a decade when stents coated with antiproliferative drug impregnated polymers, called drug-eluting stent came and became the tool of choice in almost all clinical scenarios of PTCA DESPITE the initial enthusiasm regarding the efficacy of drug-eluting coronary stents (DES) in the care of the patient with cardiovascular disease, there now seems to be a growing concern about the risk of adverse outcomes related to stent thrombosis. This initial risk became apparent in the perioperative period through a case series in which. 5. Kang SH, Park KW, Kang DY, et al. Biodegradable-polymer drug-eluting stents vs. bare metal stents vs. durable-polymer drug-eluting stents: a sys-tematic review and Bayesian approach network meta-analysis. Eur Heart J 2014;35:1147-58. REPLY: Duration of Triple Therapy in Patients Requiring Oral Anticoagulation After Drug-Eluting Stent. Multiple RCTs have demonstrated the superiority of drug-eluting stents (DES), coronary stents that provide continuous local delivery of pharmacologic inhibitors of neointimal proliferation, over traditional bare-metal stents (BMS), particularly with regard to stent restenosis, or late stent blockage due to endothelial growth within the stent

Drug-Eluting vs Bare-Metal Stents for Percutaneous

The use of first-generation drug-eluting stents (DES) has been associated with safety concerns such as very late stent thrombosis. Today, with the release of newer DES, there is a need for comparative studies of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) to demonstrate their value in patients with high risk of restenosis such as diabetic patients The decision of implanting either a drug-eluting stent or bare-metal stent depends totally on the doctor. But it is seen that at least 10-15% of those who have been implanted with a drug-eluting stent could have done equally well with a bare-metal stent. Average Cost of Stents Relevant reading: Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial In-depth [randomized controlled trial]: 173 patients with SVG were included in this study, with 89 (mean [SD] age = 70.5 [7.9] years, 89.9% male) randomized to receive DES and 84 (mean [SD] age = 71.4 [8.7] years, 89.3% male.

Acute and 1‐Year Hospitalization Costs for Acute

Background Drug-eluting stents (DES) have proven superior to bare-metal stents (BMS) in terms of safety and efficacy. However, inference to the female subgroup has been limited by low enrolment rates of women in clinical trials. The objective of this study was to investigate the safety and efficacy of DES versus BMS in women and men To report the long-term safety and efficacy data of a third generation drug eluting stent (DES) with biodegradable polymer in the complex patient population of diabetes mellitus after a follow-up period of 5 years. After percutaneous coronary intervention patients with diabetes mellitus are under higher risk of death, restenosis and stent thrombosis (ST) compared to non-diabetic patients For recommendations on drug-eluting stents for people with unstable angina, non-ST-segment-elevation myocardial infarction (NSTEMI) or ST-segment-elevation myocardial infarction (STEMI), see recommendation 1.1.18 and recommendation 1.2.18 in NICE's guideline on acute coronary syndromes. Next review: When NICE's guideline on stable angina is. Following bare-metal stenting (BMS), mortality is reduced if the NCS is performed after a period of six weeks. 1-3 Patients who have received drug-eluting stents (DES) pose a greater challenge. The period of dual antiplatelet therapy (i.e. aspirin and clopidogrel) following DES is long. While the recommended duration of therapy is four weeks.