Clinical and procedure characteristics in patients treated with polytetrafluoroethylene-covered stents after coronary perforation: a CIRC-8U multicenter registry and literature review.

This study aimed at identifying the clinical characteristics and in-hospital outcomes of patients treated with polytetrafluorethylene (PTFE)-covered stents after coronary interventions in a multicenter registry. Subjects with coronary artery perforation were selected from 31,262 consecutive patients who underwent coronary interventions in the hospital registries. Subjects were divided into two groups: those with a PTFE-covered stent implantation and those without a PTFE-covered stent implantation. Clinical characteristics and in-hospital outcomes were compared between the two groups. Data for 82 consecutive coronary perforations (15 PTFE-covered stents and 67 non-PTFE-covered stents) were extracted from each hospital registry. The PTFE-covered stent group had a higher prevalence of perforations due to pre-dilatation before stenting or post-dilatation after stenting (80% vs. 10.4%; p < 0.001), more Ellis classification III perforations (66.6% vs. 28.4%; p = 0.019), longer perforation to hemostasis time (74 min vs. 10 min; p < 0.001), lower hemostatic success rates (73.3% vs. 94.0%; p = 0.015), and higher in-hospital mortality (26.7% vs. 6.0%; p = 0.015) than the non-PTFE-covered stent group. Although the prevalence of intravascular ultrasound (IVUS) usage was high during coronary interventions (86.7%), IVUS was performed in less than half the cases just before coronary perforations (47%) in the PTFE-covered stent group. Patients requiring PTFE-covered stents are more likely to be observed after balloon dilatation before or after stenting and have a poor prognosis. Careful coronary intervention is needed when IVUS image acquisition is not achieved in addition to proper evaluation of IVUS. Furthermore, if coronary artery perforation occurs, it is important to determine the need for a prompt PTFE-covered stent.

Determination of reactive oxygen species generated by phorbol 12-myristate 13-acetate-stimulated oral polymorphonuclear cells from healthy human volunteers without any dental problems.

Human oral polymorphonuclear cells (OPMNs) play an important role in the defence of oral cavity from bacteria by releasing reactive oxygen species (ROS). The purpose of the study is to determine ROS generated by OPMNs collected from healthy volunteers without any dental problems by applying a luminol analogue 8-amino-5-chloro-7-phenylpyrido[3,4-d]pyridazine-1,4-(2H,3H)dione sodium salt-dependent chemiluminescence (CL) response in combination with radical and ROS scavengers. In the CL response induced by OPMNs primed with phorbol 12-myristate 13-acetate, 0.23 M 5,5-dimethyl-1-pyrroline N-oxide (DMPO) as a spin trap, 12.5 U/ml of super oxide dismutase (SOD) as a superoxide anion (O(2)(·-)) scavenger, and 0.96 M dimethyl sulfoxide (DMSO) as a hydroxyl radical ((·)OH) scavenger inhibited the response by approximately 90%, 70%, and 60%, respectively. The inhibitory effects were obtained in a range of concentrations where viability of the OPMNs exposed to DMPO, SOD, and DMSO were more than 70%. Electron spin resonance-spin trapping analysis confirmed that at least O(2)(·-) and (·)OH were generated via primed OPMNs. Furthermore, the addition of both 12.5 U/ml of SOD and 0.96 M DMSO inhibited the CL response by more than 90%, which was in accordance with the inhibition rate obtained by the addition of DMPO. Therefore, it is suggested that around 90% of the CL response is induced by free radicals, and at least around 70% of the radicals are SOD-inhibitable, meaning that they are originally derived from O(2)(·-). In addition, some of the (·)OH are generated independently of O(2)(·-) because if all of the (·)OH were formed through dismutation of O(2)(·-), only 70% of the CL response would be inhibited by the combination of SOD and DMSO as was inhibited by SOD alone. The present study suggests that OPMNs in health individuals have an ability to generate free radicals, which consist mainly of O(2)(·-), (·)OH and possibly an intermediate ROS derived from O(2)(·-) and (·)OH.