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Method for Combined Observation of Serial Sections of Stented Arteries Embedded in Resin by Light Microscopy and Transmission Electron Microscopy
摘要： We have developed a new method for obtaining information on whole tissues by light microscopy (LM) and ultrastructural features by transmission electron microscopy (TEM). This method uses serial sections of a stented artery embedded in resin. Stents were implanted in porcine coronary arteries in this study. The heart was perfusion fixed in a 2% paraformaldehyde and 1.25% glutaraldehyde mixed solution. The stented artery was then removed, fixed in 1% osmium, embedded in Quetol 651 resin, and sectioned serially. For LM, the black color of osmium was removed from the section by immersion in periodic acid and hydrogen peroxide after deplasticization. These sections were stained with hematoxylin and eosin and Elastica–Masson trichrome stain. For TEM, thin sections were re-embedded in Quetol 812 resin by the resupinate method and cut into ultrathin sections. A clear, fine structure was obtained, and organelles, microvilli, and cell junctions in the endothelium were easily observed. The combined observation of adjacent specimens by LM and TEM enabled us to relate histopathological changes in the millimeter scale to those in the nanometer scale.
关键词： porcine,stent,resupinate method,coronary artery,epoxy resin,transmission electron microscopy,light microscopy
更新于2025-09-23 15:22:29
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Characterisation of elemental analysis, carbon sulphur analysis and impact test of stent manufacturing using medical grade ASTM F75 cobalt chromium (CoCrMo) by selective laser melting (SLM) technology
摘要： This paper explains and demonstrates the capabilities of metal additive manufacturing (MAM) technology in producing intricate stent structure with a customise design by using ASTM F75 cobalt chromium powder. The elemental analysis (EDX-SEM), carbon sulphur analysis and Impact Test are being develop and tested and thus exploring the potential area of MAM process for future proof stent manufacturing. By alternatively switching to MAM, the step of production can be minimised and thus customisation of stent can be carried out according to the patient’s need. The suggested model of the stent was taken from the third-party vendor and fabrication was carried out using EOSINT M280 metal printer with the aid of Materialise Magics 19.0 software for support generation.
关键词： stent,scanning electron microscope (SEM),selective laser melting (SLM),cobalt chromium (CoCrMo),energy-dispersive X-ray spectroscopy (EDX),Metal additive manufacturing (MAM)
更新于2025-09-23 15:21:01
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Preparation of miRNA137 biomimetic coated coronary stent by dual-injection four-beam laser interference
摘要： In recent years, miRNA137 has shown great potential in inhibiting postoperative restenosis. In this paper, a mutual injection dual-output solid-state laser was used as the light source to construct a four-beam interferometric processing system to perform micro-nano processing on the surface of the metal coronary stent, which provides a good substrate for loading the miRNA137 onto the surface of the stent. The laser used in the experiment has a working wavelength of 1064 nm, and the energy of the two lasers is 183 mJ and 181 mJ, the energy of the four laser beams obtained by beam splitters is 97mJ, 83mJ, 95mJ and 82mJ respectively, the angle between the beams is 90 degrees and the exposure time is 60 s. When the incident angle is 14.52 degrees, a bionic micro/nano structure with a period of 3.077 μm is obtained. According to the preliminary comparative test, the structed stent with a period of 3.077μm has stronger adhesion property and longer drug release period to miRNA137 compared with the period of 1.063μm and 5.082μm.
关键词： Stent,Mutual injection laser,Micro/Nano structure,Bionic coating,MiRNA137
更新于2025-09-19 17:13:59
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Low-Profile Laser-Cut Stents for Endovascular Treatment of Intracranial Aneurysms
摘要： Purpose Low-pro?le intracranial stents are characterized by a miniaturized design that enables deployment via a 0.016500 or 0.01700 internal diameter microcatheter, which is typically intended for coil delivery. This study analyzed the incidence, clinical relevance and risk factors of thromboembolic events (TEE) occurring during low-pro?le stent-assisted coiling of intracranial aneurysms. Methods This was a retrospective, multicenter analysis of consecutive patients who underwent stent-assisted aneurysm coiling (SAC) with the laser-cut Acandis Acclino and Neuroform Atlas stents. The study evaluated the incidence of symptomatic and asymptomatic TEEs and the impact on functional outcome. Risk factors for TEEs were determined by univariate and bivariate logistic regression analyses. Results Among 131 procedures (mean patient age 56.5 ± 12.8 years, mean aneurysm size: 6.7 ± 3.9 mm) TEEs occurred in 14 cases (10.7%) of which 2 patients (1.5%) developed ischemic stroke, while the remaining TEEs remained asymptomatic. Multivariate analysis revealed Y-stenting as potential risk factor for TEEs (odds ratio: 3.9, 95% con?dence interval: 1.0–16.5; p = 0.08). Conclusion The use of SAC with low-pro?le intracranial stents is associated with a favorable safety pro?le; however, Y-stenting may carry an increased risk of TEEs, which needs to be considered during treatment planning.
关键词： Neuroform Atlas,Acandis Acclino,Stent-assisted coiling,Stroke,Thromboembolic event
更新于2025-09-16 10:30:52
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Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes
摘要： Background: Femoropopliteal (FP) artery is one of the most anatomically challenging areas for sustained stent patency. The incidence of FP in-stent restenosis (ISR) is estimated at 50% at 24 months. Prior studies have shown that lesion debulking with laser atherectomy (LA) combined with drug coated balloon (DCB) have superior outcomes compared to LA + balloon angioplasty (BA) ISR, but there have not been studies evaluating 2-year outcomes. Methods: This was a dual-center retrospective cohort study that compared patients with FP-ISR treated with LA + DCB versus LA + BA. Cox regression analysis was used to examine 2-year outcomes of target lesion revascularization (TLR) and the composite outcome of TLR or restenosis. Multivariable analysis was performed for clinical and statistically significant (in the univariate analysis) variables. Results: One hundred and seventeen consecutive patients with Tosaka II (n = 32) and III (n = 85) ISR were analyzed. Sixty-six patients were treated with LA + DCB and 51 with LA + BA. The LA + DCB group had more lesions with moderate to severe calcification (58% vs. 13%; p < .0001). The LA + DCB group was more likely to be treated with the use of embolic protection devices (64% vs. 23%, p < .001) and cutting balloons (61% vs. 6%, p < .001). Bail-out stenting rates were lower in the LA + DCB group (32% vs. 57%, p = .008). LA + DCB was superior (HR: 0.57; 95% CI: 0.34–0.9, p = .027) for the composite outcome of 2-year TLR or restenosis. The 12-month KM estimates for freedom from TLR or restenosis were 66% in the LA + DCB group versus 46% in the LA + BA group. The 24-month KM estimates were 45% in the LA + DCB group versus 24% in the LA + BA group. Conclusions: The combination of DCB + LA was associated with decreased rates of bail-out stenting and improved 2-year TLR or restenosis rates. Randomized clinical trials examining the DCB + LA combination for FP-ISR are needed.
关键词： femoropopliteal disease,drug-coated balloon,chronic total occlusions,peripheral artery disease,paclitaxel,laser,atherectomy,in-stent restenosis
更新于2025-09-12 10:27:22
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Time evolution of angular momentum coherent state derived by virtue of entangled state representation and a new binomial theorem
摘要： Objective: This study explored the clinical efficacy and hemodynamic effects of the micropore stent graft (MSG) that could promote aortic remodeling and preserve important organ branches. Methods: We conducted a retrospective analysis of 26 patients who underwent endovascular repair using an MSG for DeBakey types I and III TAD at our center between December 2014 and December 2017. The main efficacy parameters were rupture of the false lumen or dissection-related death, conversion to open repair, secondary reintervention, branch vessel patency, and the hemodynamic effects of TAD at 12 months. Results: Dissection rupture, dissection-related mortality, conversion to open repair, and secondary reintervention rates at 12 months were 0, 3.9, 0, and 0%, respectively. In the 24 patients with more than 6 months of follow-up, micropore stents were implanted to cover 39 openings in aortic arch branches, 91.7% (22/24) presented with complete thrombosis in the false lumen, 8.3% (2/24) presented with partial thrombosis in the false lumen, 35.2% (6/17) presented with a thrombus in the false lumen that was completely absorbed, and all 39 branches were patent. After surgery, pressure peak value and fluctuation along with the degree and range of unstable blood flow in the aortic lumen decreased. Conclusions: For type I and type III thoracic artic dissection, endovascular treatment with an MSG may be a safe and effective treatment option with a good midterm outcome.
关键词： endovascular repair,micropore stent graft,patency rate,thoracic aortic dissection,hemodynamics
更新于2025-09-11 14:15:04
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Different Neoatherosclerosis Patterns in Drug-Eluting- and Bare-Metal Stent Restenosis ― Optical Coherence Tomography Study ―
摘要： Background: There are few reports about the differences between drug-eluting stents (DES) and bare metal stents (BMS) in neoatherosclerosis associated with in-stent restenosis (ISR), so we compared the frequency and characteristics of neoatherosclerosis with ISR evaluated by optical coherence tomography (OCT) in the present study. Methods and Results: Between March 2009 and November 2016, 98 consecutive patients with ISR who underwent diagnostic OCT were enrolled: 34 patients had a BMS, 34 had a 1st-generation DES, and 30 had a 2nd-generation DES. Neoatherosclerosis was defined as a lipid neointima (including a thin-cap fibroatheroma [TCFA] neointima, defined as a fibroatheroma with a fibrous cap <65 μm) or calcified neointima. As a result, lipid neointima, TCFA neointima and calcified neointima were detected in 39.8%, 14.3%, and 5.1%, respectively, of all patients. The frequency of neoatherosclerosis was significantly greater with DES than BMS (48.4% vs. 23.5%, P=0.018). The minimum fibrous cap thickness was significantly thicker with DES than BMS (110.3±41.1 μm vs. 62.5±17.1 μm, P<0.001). In addition, longitudinal extension of neoatherosclerosis in the stented segment was less with DES than BMS (20.2±15.1% vs. 71.8±27.1%, respectively, P=0.001). Conclusions: OCT imaging demonstrated that neoatherosclerosis with ISR was more frequent with DES than BMS and its pattern exhibited a more focal and thick fibrous cap as compared with BMS.
关键词： Optical coherence tomography,Neoatherosclerosis,In-stent restenosis
更新于2025-09-11 14:15:04
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“Baumkuchen” Structure Assessed by Optical Coherence Tomography After 15?Years of Bare-Metal Stent Implantation
摘要： A 64-year old man who had hypertension, diabetes, and dyslipidemia was admitted to our hospital with worsening chest pain. He has undergone percutaneous coronary intervention (PCI) for placement of a bare-metal stent in the proximal left anterior descending coronary artery (LAD) 15 years ago. Urgent coronary angiography revealed in-stent restenosis at the proximal LAD, then ad hoc PCI was performed. Optical coherence tomography (OCT) pre-procedure revealed a “Baumkuchen-like” structure with triple layers according to the neointimal OCT signal pattern at the narrowed segment. Because a scoring balloon failed to dilate the lesion properly, rotational atherectomy was applied for lesion modification. After atherectomy, the lesion was fully expanded by noncompliant balloon followed by successful drug-eluting stent implantation. Follow-up angiography and OCT at 6 months revealed no angiographic restenosis and minimal neointimal hyperplasia. Here, we report for the first time to our knowledge a case with multiple layers of intima and neo-atherosclerosis, assessed by OCT, 15 years after PCI. Further investigation is warranted to verify whether this unique OCT finding will help us to elucidate the mechanism of neoatherosclerosis in metallic stents and to consider the appropriate strategy of revascularization, particularly in very late in-stent restenosis cases.
关键词： in-stent restenosis,optical coherence tomography,multiple signal layer,bare-metal stent(s)
更新于2025-09-10 09:29:36
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P2636Comparison of the efficacy of balloon angioplasty or paclitaxel-coated balloon or stent implantation for in-stent restenosis based on analysis by optical coherence tomography
摘要： We could distinguish the restenotic tissue structure patterns in detail by optical coherence tomography (OCT). We hypothesized that the recurrent restenosis of the in-stent restenosis (ISR) lesions might be different among restenotic tissue structure patterns analyzed by OCT. The purpose of this study was to investigate the efficacy of balloon angioplasty (BA) or paclitaxel-coated balloon (PCB) or stent implantation (SI) for the treatment of the in-stent restenosis (ISR) based on the restenotic tissue structure analyzed by optical coherence tomography (OCT). From January 2010 to September 2016, we evaluated 330 patients with 365 ISR lesions that required revascularization (281 drug-eluting stents (DES) and 84 bare-metal stents (BMS)). Based on their OCT appearance at the minimum lumen area, the lesions were classified as homogeneous and non-homogeneous. We compared recurrent target lesion revascularization (TLR) at 1year follow-up after BA or PCB or SI. By OCT, the restenotic tissue structure was homogeneous in 149 (41%) and non-homogeneous in 216 (59%). In homogeneous group, 55 patients had BA, 45 patients had PCB and 49 patients had SI. In non-homogeneous group, 87 patients had BA, 50 patients had PCB and 79 patients had SI. Angiographic follow-up after TLR was performed in 263 patients (80%) with 294 lesions (81%) at 1 year. As OCT appeared homogeneous, recurrent TLR was noted in 22% of BA group, in 13% of PCB group and in 16% of SI group (p=0.5). As OCT appeared non-homogeneous, recurrent TLR occurred in 33% of BA group, in 14% of PCB group and in 13% of SI group (p=0.002). We concluded that morphological assessment of restenotic tissue by OCT might be helpful to decide the treatment strategies of ISR.
关键词： imaging,paclitaxel-coated balloon,balloon angioplasty,Stents,stent implantation,Coronary interventions,in-stent restenosis,optical coherence tomography,Coronary physiology
更新于2025-09-10 09:29:36
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Association Between TG-to-HDL-C Ratio and In-Stent Stenosis Under Optical Coherence Tomography Guidance
摘要： We determined the relevance between the TG-to-HDL-C ratio and stent restenosis. Ninety-nine patients with in-stent stenosis (ISR) who were admitted to An Zhen Hospital in Beijing between April 2014 and June 2017 were selected. At the same time, 122 patients with coronary stenosis <50% were selected. All patients were tested for TG, HDL-C, and TG/HDL-C ratio. Optical coherence tomography (OCT) can assess microscopic status in all ISR patients. The proportion of male and Diabetic patients were significantly higher for ISR. There were differences in the prevalence of cigarette smokers among the different tissue types, among which the layered tissue type accounted for the highest proportion. In logistic regression analysis the study showed that male, diabetes mellitus, and the TG/HDL-C ratio are risk factors for ISR. The ISR ROC was 0.725 based on the TG/HDL-C ratio diagnosis. It is related to the degree of coronary stenosis and effective in diagnosing in-stent stenosis in ISR.
关键词： Optical coherence tomography,In-stent restenosis,TG-to-HDL ratio,Coronary heart disease
更新于2025-09-10 09:29:36