Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21
Filtrar
Mais filtros










Tipo de estudo
Intervalo de ano de publicação
1.
EuroIntervention ; 2020 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-32149709

RESUMO

AIMS: The novel sirolimus-eluting ultra-high molecular weight 115-microns strut thickness APTITUDE® Bioreabsorbable vascular scaffold (BRS) (Amaranth Medical Inc., Mountain View, CA) displays higher mechanical strength, expansion capabilities and resistance to fracture compared to clinically available BRS technologies. RENASCENT II is a prospective, multi-center first-in-human clinical study to evaluate the clinical performance of the APTITUDE® BRS in the treatment of single de novo coronary lesions among patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: APTITUDE® BRS was tested in a prospective study in two countries (Italy and Colombia). Study objectives were angiographic in-scaffold late lumen loss (IS-LLL) measured by quantitative coronary angiography (QCA) and target vessel failure (TVF) defined as the composite rate of cardiac death, target vessel myocardial infarction (TV-MI) or ischemia driven target lesion revascularization (TLR) at 9-and 24-months. A total of 60 patients were enrolled. All patients underwent lesion pre-dilatation and 46 patients (76.7%) underwent post-dilatation. Clinical device and procedural success were 98.3% (59/60 patients) and 100% respectively. Angiographic late lumen loss was 0.19 ± 0.26mm at 9-months and 0.3 ± 0.41mm at 24-months. At 9-months, TVF occurred in 2/59 (3.4%) due to TV-MI but no TLR. No further cases of TVF, MACE or stent thrombosis were reported upto 24-months follow-up. CONCLUSIONS: In this multi-center prospective study, the APTITUDE® BRS was shown to be safe and effective in the treatment of single coronary lesions at 24-months clinical follow up.

2.
Data Brief ; 26: 104521, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31667284

RESUMO

The data presented in this paper is supporting the research article "Estimating wind dispersal potential in Ailanthus altissima: The need to consider the three-dimensional structure of samaras" [1]. We analyzed the estimation of samara's wind dispersal potential through a group of morphological variables that succeed in describing the three-dimensional nature of samaras. We present here a dataset containing 8 morphological variables of 200 samaras belonging to 5 different individuals of the invasive tree Ailanthus altissima (Mill.) Swingle. Additionally, we present the average descent velocity of each of the samaras, which was recorded by releasing 5 times each samara under controlled and reproducible conditions. The data set is structured in a single spreadsheet where we also included the samara and the individual identity code of the tree.

3.
Front Plant Sci ; 9: 727, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29904391

RESUMO

Crown architecture usually is heterogeneous as a result of foraging in spatially and temporally heterogeneous light environments. Ecologists are only beginning to identify the importance of temporal heterogeneity for light acquisition in plants, especially at the diurnal scale. Crown architectural heterogeneity often leads to a diurnal variation in light interception. However, maximizing light interception during midday may not be an optimal strategy in environments with excess light. Instead, long-lived plants are expected to show crown architectures and leaf positions that meet the contrasting needs of light interception and avoidance of excess light on a diurnal basis. We expected a midday depression in the diurnal course of light interception both at the whole-crown and leaf scales, as a strategy to avoid the interception of excessive irradiance. We tested this hypothesis in a population of guava trees (Psidium guajava L.) growing in an open tropical grassland. We quantified three crown architectural traits: intra-individual heterogeneity in foliage clumping, crown openness, and leaf position angles. We estimated the diurnal course of light interception at the crown scale using hemispheric photographs, and at the leaf scale using the cosine of solar incidence. Crowns showed a midday depression in light interception, while leaves showed a midday peak. These contrasting patterns were related to architectural traits. At the crown scale, the midday depression of light interception was linked to a greater crown openness and foliage clumping in crown tops than in the lateral parts of the crown. At the leaf scale, an average inclination angle of 45° led to the midday peak in light interception, but with a huge among-leaf variation in position angles. The mismatch in diurnal course of light interception at crown and leaf scales can indicate that different processes are being optimized at each scale. These findings suggest that the diurnal course of light interception may be an important dimension of the resource acquisition strategies of long-lived woody plants. Using a temporal approach as the one applied here may improve our understanding of the diversity of crown architectures found across and within environments.

4.
Catheter Cardiovasc Interv ; 92(3): E246-E253, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29243353

RESUMO

OBJECTIVES: In this first-in-human study, we prospectively studied the vascular compatibility and mechanical performance of a novel bare ultra-high molecular weight amorphous PLLA bioresorbable scaffold (BRS, FORTITUDE®, Amaranth Medical, Mountain View, California) up to two years after implantation using multimodality imaging techniques. BACKGROUND: The vascular biocompatibility of polymers used in BRS has not been fully characterized in the absence of anti-proliferative drugs. METHODS: A total of 10 patients undergoing single scaffold implantation were included in the final analysis and were followed up using optical coherence tomography (OCT) at 2-years. All devices were implanted under angiographic and intravascular ultrasound (IVUS) guidance. Angiographic and IVUS follow up was performed at 6 months. Additionally, angiography and OCT imaging were performed at 2-years. RESULTS: At 6 months, mean intra-scaffold angiographic MLD slightly decreased from baseline procedural values. However, at 2 years, mean angiographic MLD increased (post procedure; 2.9 [2.7, 3.1] mm vs. 6 months; 2.1 [1.6, 2.5] vs. 2 years; 2.4 [2.1, 2.6], P = .001). Also, angiographic percent diameter stenosis decreased and late lumen gain increased between 6 months and 2 years follow up. Mean neointimal hyperplasia volume assessed by IVUS at 6 months was 26% [15.2, 29.3]. At 2 years OCT follow up neointimal hyperplasia volume was 24.2% [19.4, 28.9]. No presence of neoatherosclerosis was identified in any of the analyzed cases. CONCLUSION: At 2 years, this novel PLLA-based BRS induced expansive vascular remodeling from 6 to 24 months, a biological phenomenon that appears to be independent of the presence of anti-proliferative drugs.


Assuntos
Implantes Absorvíveis , Angiografia Coronária , Doença da Artéria Coronariana/terapia , Vasos Coronários/diagnóstico por imagem , Intervenção Coronária Percutânea/instrumentação , Poliésteres/química , Tomografia de Coerência Óptica , Ultrassonografia de Intervenção , Remodelação Vascular , Idoso , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/patologia , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/patologia , Vasos Coronários/fisiopatologia , Estudos de Viabilidade , Feminino , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Peso Molecular , Imagem Multimodal , Neointima , Intervenção Coronária Percutânea/efeitos adversos , Valor Preditivo dos Testes , Estudos Prospectivos , Desenho de Prótese , Fatores de Tempo , Resultado do Tratamento
5.
Open Heart ; 4(1): e000521, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28674616

RESUMO

OBJECTIVE: To evaluate the biological effect of microengineered stent grooves (MSG) on early strut healing in humans by performing optical coherence tomography (OCT) analysis 3 weeks following the implantation. BACKGROUND: In the experimental setting, MSG accelerate endothelial cell migration and reduce neointimal proliferation compared with bare metal stent (BMS). METHODS: A total of 37 patients undergoing percutaneous coronary intervention with de novo coronary lesions were randomly assigned to either MSG (n=19) or an identical BMS controls (n=18). All patients underwent OCT imaging at 3 weeks. A total of 7959 struts were included in the final analysis. RESULTS: At 3 weeks following stent implantation, almost all struts analysed (~97%) had evidence of tissue coverage. The percentage of partially covered struts was comparable between both groups. However, the percentage of fully embedded struts was higher in the BMS group (81.22%, 49.75-95.52) compared with the MSG group (74.21%, 58.85-86.38). The stent-level analysis demonstrated reduction in neointimal formation (neointimal hyperplasia area and volume reduction of ~14% and ~19%, respectively) in the MSG versus the BMS group. In the strut-level analysis, an even greater reduction (~22% in neointimal thickness) was seen in the MSG group. Layered neointimal was present in ~6% of the OCT frames in the BMS group while it was not present in the MSG group. CONCLUSIONS: MSG induced a more homogeneous and predictable pattern of surface healing in the early stages following stent implantation. The biological effect of MSG on stent healing has the potential to improve the safety profile of current generation drug-eluting stents. CLASSIFICATIONS: BMS, OCT, clinical trials.

6.
Zootaxa ; 4238(4): 451-498, 2017 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-28603247

RESUMO

Preimaginal stages of the six species of Hydraenidae presently known from Cuba were obtained by rearing adults in the laboratory. Eggs of Hydraena perkinsi Spangler, 1980, H. decui Spangler, 1980 and H. franklyni Deler-Hernández & Delgado, 2012 are described and illustrated for the first time. The first instar larva of Gymnochthebius fossatus (LeConte, 1855) is redescribed, adding some new remarkable morphological characters including what could be the first abdominal egg-burster reported for this family. All larval instars of H. perkinsi, H. guadelupensis Orchymont, 1923 and Ochthebius attritus LeConte, 1878 are described and illustrated for the first time, with a special emphasis on their chaetotaxy. The second instar larva of G. fossatus along with first and third instar larvae of H. decui and H. franklyni are also studied for the first time. The pupal morphology and vestiture of a species belonging to the genus Hydraena are described for the first time, based on the pupa of H. perkinsi. Biological notes for several preimaginal stages of the studied species are also given.


Assuntos
Besouros , Animais , Cuba , Larva , Óvulo , Pupa
7.
Zootaxa ; 4250(5): 434-446, 2017 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-28610000

RESUMO

Two new species of the genus Hydraena Kugelann, 1794 collected from hygropetric habitats in eastern Cuba are described: Hydraena (Hydraenopsis) blancae sp. nov. from the Nipe-Sagua-Baracoa mountain range, and Hydraena (Hydraenopsis) matthiasi sp. nov. from the Sierra Maestra mountain range. Both species, especially the latter, are closely related to Hydraena (Hydraenopsis) franklyni Deler-Hernández & Delgado, 2012. Diagnostic characters for both new species are provided and illustrated; habitat information and distributional data are also included. An updated key to Cuban species of Hydraena is provided. With this study, the number of species of Hydraena known from Cuba raises to six.


Assuntos
Besouros , Animais , Cuba , Ecossistema
8.
Coron Artery Dis ; 28(2): 126-134, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27879518

RESUMO

AIMS: Bioresorbable polymer drug-eluting stent technologies have been considered to have the potential to enhance vascular healing by reducing polymer exposure to the vessel wall, potentially allowing the earlier discontinuation of dual antiplatelet therapy. At present, the early vascular healing response to this type of technologies is still unclear. PATIENTS AND METHODS: The TIMELESS study is a multicenter, prospective, single-arm study that enrolled real-world patients undergoing percutaneous coronary intervention. All patients underwent Synergy stent implantation, which consists of a platinum-chromium platform coated with an ultra-thin abluminal bioabsorbable poly-D,L-lactide-co-glycolide polymer-eluting everolimus. RESULTS: A total of 37 patients were included in the study. The majority of the patients underwent percutaneous coronary intervention because of acute coronary syndromes. At 3 months, angiographic follow-up showed a percentage diameter of stenosis of 8.1±7.5% and an angiographic late loss of 0.03±0.24 mm. In all analyzed struts, less than 1% of struts were definitely uncovered or covered with fibrin, 12.5% (5.0-18.5%) showed evidence of partial coverage, and the remaining (∼85%) were fully covered. No stent thrombosis was observed up to 12 months of clinical follow-up. CONCLUSION: In a real-world population, the implantation of a bioresorbable polymer drug-eluting stent resulted in almost complete strut coverage throughout the entire stent length at 3 months. The clinical implications for antiplatelet therapy and outcomes should be investigated further.


Assuntos
Implantes Absorvíveis , Síndrome Coronariana Aguda/terapia , Fármacos Cardiovasculares/administração & dosagem , Doença da Artéria Coronariana/terapia , Estenose Coronária/terapia , Vasos Coronários/efeitos dos fármacos , Stents Farmacológicos , Everolimo/administração & dosagem , Ácido Láctico/química , Intervenção Coronária Percutânea/instrumentação , Ácido Poliglicólico/química , Tomografia de Coerência Óptica , Cicatrização/efeitos dos fármacos , Síndrome Coronariana Aguda/diagnóstico por imagem , Idoso , Fármacos Cardiovasculares/efeitos adversos , Cromo , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Quimioterapia Combinada , Everolimo/efeitos adversos , Feminino , Humanos , Masculino , Intervenção Coronária Percutânea/efeitos adversos , Inibidores da Agregação de Plaquetas/administração & dosagem , Platina , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Valor Preditivo dos Testes , Desenho de Prótese , Fatores de Tempo , Resultado do Tratamento
9.
Zookeys ; (623): 75-88, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27843389

RESUMO

Hydraena matyotisp. n. (Coleoptera, Hydraenidae) is described from the Seychelles, Indian Ocean. Hydraena mahensis Scott, 1913 is redescribed. The latter is here recorded from La Digue for the first time. A key to the species of the genus Hydraena Kugelann, 1794 of the Seychelles is presented.

10.
Ann Bot ; 117(4): 643-51, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26944783

RESUMO

BACKGROUND: The spatial arrangement and expression of foliar syndromes within tree crowns can reflect the coupling between crown form and function in a given environment. Isolated trees subjected to high irradiance and concomitant stress may adjust leaf phenotypes to cope with environmental gradients that are heterogeneous in space and time within the tree crown. The distinct expression of leaf phenotypes among crown positions could lead to complementary patterns in light interception at the crown scale. METHODS: We quantified eight light-related leaf traits across 12 crown positions of ten isolated Olea europaea trees in the field. Specifically, we investigated whether the phenotypic expression of foliar traits differed among crown sectors and layers and five periods of the day from sunrise to sunset. We investigated the consequences in terms of the exposed area of the leaves at the tree scale during a single day. KEY RESULTS: All traits differed among crown positions except the length-to-width ratio of the leaves. We found a strong complementarity in the patterns of the potential exposed area of the leaves among day periods as a result of a non-random distribution of leaf angles across the crown. Leaf exposure at the outer layer was below 60 % of the displayed surface, reaching maximum interception during morning periods. Daily interception increased towards the inner layer, achieving consecutive maximization from east to west positions within the crown, matching the sun's trajectory. CONCLUSIONS: The expression of leaf traits within isolated trees of O. europaea varies continuously through the crown in a gradient of leaf morphotypes and leaf angles depending on the exposure and location of individual leaves. The distribution of light-related traits within the crown and the complementarity in the potential exposure patterns of the leaves during the day challenges the assumption of low trait variability within individuals.


Assuntos
Luz , Olea/fisiologia , Olea/efeitos da radiação , Folhas de Planta/fisiologia , Folhas de Planta/efeitos da radiação , Árvores/fisiologia , Árvores/efeitos da radiação , Modelos Lineares , Característica Quantitativa Herdável , Fatores de Tempo
11.
PLoS One ; 9(10): e107709, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25272037

RESUMO

Insect phylogeny has recently been the focus of renewed interest as advances in sequencing techniques make it possible to rapidly generate large amounts of genomic or transcriptomic data for a species of interest. However, large numbers of markers are not sufficient to guarantee accurate phylogenetic reconstruction, and the choice of the model of sequence evolution as well as adequate taxonomic sampling are as important for phylogenomic studies as they are for single-gene phylogenies. Recently, the sequence of the genome of a strepsipteran has been published and used to place Strepsiptera as sister group to Coleoptera. However, this conclusion relied on a data set that did not include representatives of Neuropterida or of coleopteran lineages formerly proposed to be related to Strepsiptera. Furthermore, it did not use models that are robust against the long branch attraction artifact. Here we have sequenced the transcriptomes of seven key species to complete a data set comprising 36 species to study the higher level phylogeny of insects, with a particular focus on Neuropteroidea (Coleoptera, Strepsiptera, Neuropterida), especially on coleopteran taxa considered as potential close relatives of Strepsiptera. Using models robust against the long branch attraction artifact we find a highly resolved phylogeny that confirms the position of Strepsiptera as a sister group to Coleoptera, rather than as an internal clade of Coleoptera, and sheds new light onto the phylogeny of Neuropteroidea.


Assuntos
Genômica , Insetos/classificação , Insetos/genética , Filogenia , Animais , Feminino , Masculino , Modelos Genéticos , RNA Ribossômico
12.
PLoS One ; 9(4): e93614, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24709670

RESUMO

Derived members of the endoparasitic order Strepsiptera have acquired an extreme form of sexual dimorphism whereby males undergo metamorphosis and exist as free-living adults while females remain larviform, reaching sexual maturity within their hosts. Expression of the transcription factor, broad (br) has been shown to be required for pupal development in insects in which both sexes progress through metamorphosis. A surge of br expression appears in the last larval instar, as the epidermis begins pupal development. Here we ask if br is also up-regulated in the last larval instar of male Xenos vesparum Rossi (Stylopidae), and whether such expression is lost in neotenic larviform females. We clone three isoforms of br from X. vesparum (Xv'br), and show that they share greatest similarity to the Z1, Z3 and Z4 isoforms of other insect species. By monitoring Xv'br expression throughout development, we detect elevated levels of total br expression and the Xv'Z1, Xv'Z3, and Xv'Z4 isoforms in the last larval instar of males, but not females. By focusing on Xv'br expression in individual samples, we show that the levels of Xv'BTB and Xv'Z3 in the last larval instar of males are bimodal, with some males expressing 3X greater levels of Xv'br than fourth instar femlaes. Taken together, these data suggest that neoteny (and endoparasitism) in females of Strepsiptera Stylopidia could be linked to the suppression of pupal determination. Our work identifies a difference in metamorphic gene expression that is associated with neoteny, and thus provides insights into the relationship between metamorphic and neotenic development.


Assuntos
Regulação da Expressão Gênica/fisiologia , Proteínas de Insetos/biossíntese , Insetos/metabolismo , Metamorfose Biológica/fisiologia , Fatores de Transcrição/biossíntese , Animais , Feminino , Proteínas de Insetos/genética , Insetos/genética , Masculino , Pupa/genética , Pupa/metabolismo , Fatores de Transcrição/genética
13.
J Am Coll Cardiol ; 61(15): 1596-600, 2013 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-23500318

RESUMO

OBJECTIVES: The aim of this study was to evaluate the safety as well as the clinical and technical effectiveness of robotic-assisted percutaneous coronary intervention. BACKGROUND: Robotic systems have been suggested to enhance the performance of cardiovascular procedures, as well as to provide protection from the occupational hazards that are associated with interventional practice. METHODS: Patients with coronary artery disease and clinical indications for percutaneous intervention were enrolled. The coronary intervention was performed with the CorPath 200 robotic system, which consists of a remote interventional cockpit and a bedside disposable cassette that enables the operator to advance, retract, and rotate guidewires and catheters. The primary endpoints were clinical procedural success, defined as <30% residual stenosis at the completion of the robotic-assisted procedure without major adverse cardiovascular events within 30 days, and device technical success, defined as the successful manipulation of the intracoronary devices using the robotic system only. RESULTS: A total of 164 patients were enrolled at 9 sites. Percutaneous coronary intervention was completed successfully without conversion to manual operation, and device technical success was achieved in 162 of 164 patients (98.8%). There were no device-related complications. Clinical procedural success was achieved in 160 of 164 patients (97.6%), whereas 4 (2.4%) had periprocedural non-Q-wave myocardial infarctions. No deaths, strokes, Q-wave myocardial infarctions, or revascularization occurred in the 30 days after the procedures. Radiation exposure for the primary operator was 95.2% lower than the levels found at the traditional table position. CONCLUSIONS: This pivotal multicenter study with a robotic-enhanced coronary intervention system demonstrated the safety and feasibility of the system. The robotic remote-control procedure met the expected technical and clinical performance, with significantly lower radiation exposure to the operator. (Evaluation of the Safety and Effectiveness of the CorPath 200 System in Percutaneous Coronary Interventions [PCI] [PRECISE]; NCT01275092).


Assuntos
Doença da Artéria Coronariana/cirurgia , Infarto do Miocárdio , Exposição Ocupacional/prevenção & controle , Intervenção Coronária Percutânea , Complicações Pós-Operatórias/epidemiologia , Robótica , Idoso , Cateteres , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Desenho de Equipamento/métodos , Desenho de Equipamento/normas , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Salas Cirúrgicas , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Intervenção Coronária Percutânea/estatística & dados numéricos , Saúde Radiológica , Medição de Risco , Robótica/métodos , Robótica/estatística & dados numéricos , Stents , Resultado do Tratamento , Recursos Humanos
14.
Insects ; 4(3): 463-75, 2013 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-26462430

RESUMO

The unusual life style of Strepsiptera has presented a long-standing puzzle in establishing its affinity to other insects. Although Strepsiptera share few structural similarities with other insect orders, all members of this order share a parasitic life style with members of two distinctive families in the Coleoptera-the order now considered the most closely related to Strepsiptera based on recent genomic evidence. Among the structural features of several strepsipteran families and other insect families that have been surveyed are the organization of testes and ultrastructure of sperm cells. For comparison with existing information on insect sperm structure, this manuscript presents a description of testes and sperm of a representative of the most primitive extant strepsipteran family Mengenillidae, Eoxenos laboulbenei. We compare sperm structure of E. laboulbenei from this family with that of the three other families of Strepsiptera in the other strepsipteran suborder Stylopidia that have been studied as well as with members of the beetle families Meloidae and Rhipiphoridae that share similar life histories with Strepsiptera. Meloids, Rhipiphorids and Strepsipterans all begin larval life as active and viviparous first instar larvae. This study examines global features of these insects' sperm cells along with specific ultrastructural features of their organelles.

15.
Zootaxa ; 3700: 195-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-26106722

RESUMO

Ochthebius hivae is described from western Iran (Ilam and Khuzestan Provinces). It belongs to the O. metallescens Rosenhauer, 1847 species group. The aedeagal distal lobe of this species is remarkably variable.


Assuntos
Besouros/anatomia & histologia , Besouros/classificação , Distribuição Animal , Animais , Feminino , Irã (Geográfico) , Masculino , Caracteres Sexuais , Especificidade da Espécie
16.
EuroIntervention ; 7(7): 780-8, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22082574

RESUMO

AIMS: Earlier generation self-expanding stents (SExS) showed high restenosis rates and long-term stent over-expansion. A novel SExS with reduced outward expansive force has been developed to overcome these limitations. This first-in-human study aimed to evaluate the safety and feasibility of the low pressure self-expanding nitinol-based vProtect™ luminal shield (LS) in the treatment of intermediate coronary lesions. METHODS AND RESULTS: A total of 29 patients with clinical evidence of myocardial ischaemia and intermediate de novo coronary lesions were included. The LS was deployed after low-pressure balloon pre-dilatation. Acute procedural and device success was achieved in all patients. Angiographic follow-up at nine months showed an in-stent lumen loss of 0.50±0.30 mm and a binary restenosis rate of 10.3%. There were no cases of late LS over-expansion or acute/late malapposition as evaluated by intravascular ultrasound (IVUS). The cumulative major adverse cardiac events (MACE) rate at nine months was 10.3%, consisting of three target lesion revascularisations, with no cases of death, myocardial infarction or stent thrombosis. CONCLUSIONS: Implantation of the LS in non-complex coronary lesions of intermediate severity was feasible, safe, and resulted in low rates of late loss and restenosis. IVUS analysis at nine months showed favourable mechanical properties of the LS without evidence of late device over-expansion.


Assuntos
Angioplastia Coronária com Balão/instrumentação , Doença da Artéria Coronariana/terapia , Stents , Idoso , Ligas , Angioplastia Coronária com Balão/efeitos adversos , Colômbia , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia de Intervenção
17.
JACC Cardiovasc Interv ; 4(4): 460-5, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21511227

RESUMO

OBJECTIVES: We aimed to evaluate the safety and feasibility of a robotic angioplasty system in delivery and manipulation of coronary guidewires, balloons, and stents in patients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND: A remote-control, robotic-assisted angioplasty system is under development to address some of the procedural challenges and occupational hazards associated with traditional PCI. METHODS: Patients with coronary artery disease and clinical indication for elective PCI were enrolled. The coronary angioplasty procedure was performed with the CorPath 200 robotic system (Corindus, Inc., Natick, Massachusetts). The system consists of a remote interventional cockpit and a multicomponent bedside unit that enables the operator to advance, retract, and rotate guidewires and rapid exchange catheters. The primary endpoint was device clinical success (≤ 30% residual stenosis) without in-hospital major adverse cardiac events. Technical success was defined as the ability of the system to complete all the planned angioplasty steps on the basis of procedural segments. Patients were followed up to 30 days after angioplasty procedure. RESULTS: A total of 8 patients were enrolled in the study. The primary endpoint was achieved in all patients (100%). The technical success of the robotic system was 97.9% in completing 47 of 48 planned steps. There were no device- or procedure-related complications and no in-hospital or 30-day major adverse cardiac events. The operators rated the robotic system performances as equal to or better than manual procedures in 97.5% of the cases. The operator radiation exposure was 97% lower than the levels found at the standard table position. CONCLUSIONS: Early clinical experience with a robotic-assisted angioplasty system demonstrated feasibility, safety, and procedural effectiveness comparable to manual operation. In addition, the total operator exposure to radiation was significantly low. A larger study is warranted to verify the safety and effectiveness of robotic-assisted percutaneous coronary intervention.


Assuntos
Angioplastia Coronária com Balão/instrumentação , Doença da Artéria Coronariana/terapia , Robótica , Terapia Assistida por Computador/instrumentação , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Cateteres , Colômbia , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Medição de Risco , Fatores de Risco , Stents , Resultado do Tratamento
18.
Am J Cardiol ; 107(1): 6-9, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21146678

RESUMO

In large clinical trials enrolling patients with acute coronary syndromes, a high loading dose of clopidogrel (600 mg) has been found to be more effective compared to a low loading dose (300 mg). However, the applicability of these data to stable patients who undergo elective percutaneous coronary intervention is still unclear. A total of 400 patients who underwent elective PCI were prospectively randomized to receive either 600 mg (n = 200) or 300 mg (n = 200) of clopidogrel, followed by a daily maintenance dose of 75 mg. The primary end point was the presence of major adverse cardiovascular events (combined death, myocardial infarction, acute neurologic event, stent thrombosis, and need for percutaneous or surgical revascularization of the target vessel) during hospitalization and at 30 days. The secondary end point was periprocedural vascular complications, major bleeding, and cardiac enzyme elevation. There were no differences in the primary end point among the groups immediately after the procedure (3.5% of patients in the 300-mg group vs 4.5% of those in the 600-mg group, p = 0.799) or at 30 days (6% vs 5%, respectively, p = 0.826). The rates of periprocedural vascular complications (2.5% vs 3%, respectively, p = 1.00), bleeding complications (9% vs 8.5%, respectively, p = 1.00), and cardiac enzyme elevation (11% vs 15.5%, respectively, p = 0.317) were similar between the 2 groups. In conclusion, adverse cardiovascular events and bleeding complications during the initial hospitalization and at 30-day follow-up were similar when a 600-mg loading dose of clopidogrel was used compared to the conventional dose of 300 mg.


Assuntos
Síndrome Coronariana Aguda/terapia , Angioplastia Coronária com Balão , Hemorragia/induzido quimicamente , Inibidores da Agregação de Plaquetas/administração & dosagem , Ticlopidina/análogos & derivados , Síndrome Coronariana Aguda/tratamento farmacológico , Idoso , Clopidogrel , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ticlopidina/administração & dosagem , Ticlopidina/efeitos adversos , Resultado do Tratamento
19.
Rev. colomb. cardiol ; 14(6): 341-352, nov.-dic. 2007. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: lil-481978

RESUMO

Introducción: estudios recientes demuestran la seguridad y eficacia de la implantación de células progenitoras derivadas de la médula ósea y de la administración del factor estimulante de colonias de granulocito en pacientes con infarto agudo del miocardio con elevación del segmento ST y en cardiopatía isquémica crónica. Se diseñó un estudio prospectivo, abierto de ®antes y después¼ para evaluar la seguridad y eficacia de la terapia celular asociada a la administración del factor de crecimiento. Se reporta la primera experiencia con este tipo de terapia.Metodología: este es el reporte del seguimiento a seis meses, de los pacientes con cardiopatía isquémica aguda y crónica a quienes se les realizó trasplante de células progenitoras derivadas de la médula ósea, movilizadas con factor de crecimiento estimulante de colonias de granulocitos, por vía intracoronaria o epicárdica. Se incluyeron dos grupos de pacientes: 1. Diez pacientes con infarto de pared anterior y 2. Cinco pacientes con cardiopatía isquémica crónica, todos con necrosis extensa demostrada por ausencia de viabilidad miocárdica por medicina nuclear y fracción de eyección menor del 40 porciento...


Assuntos
Medula Óssea , Infarto do Miocárdio , Transplante de Células-Tronco , Células-Tronco
20.
Rev. colomb. cardiol ; 11(4): 213-218, jul.-ago. 2004. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-438407

RESUMO

Introducción: estudios en animales demuestran la capacidad de las células progenitoras derivadas de la médula ósea de diferenciarse en cardiomiocitos, células endoteliales y de músculo liso, con lo cual se logra regenerar tejido miocárdico y revasculizarlo. Estudios clínicos en humanos demuestran la factibilidad y seguridad de la utilización de las células madre para recuperar la función ventricular en pacientes con infarto agudo de miocardio. Se reporta la primera experiencia en Colombia con este tipo de terapia.Metodología: este es el reporte del seguimiento a dos meses, de los pacientes con infarto agudo de miocardio de cara anterior a quienes se les realizó trasplante de células progenitoras derivadas de la médula ósea, movilizadas con factor de crecimiento estimulante de colonias de granulocito-macrófago, posterior a la revascularización percutánea con angioplastia e implantación de stent.Resultados: se incluyeron tres pacientes con infarto de cara anterior, necrosis extensa demostrada por ausencia de viabilidad miocárdica por medicina nuclear y fracción de eyección menor del 40 porciento. Se demostró mejoría de la fracción de eyección y disminución del volumen ventricular sistólico en la ecocardiografía de control. La capacidad de ejercicio aumentó en forma significativa y se evidenció por incremento en las pruebas de los seis minutos, el tiempo de ejercicio y el número de Met alcanzados. No hubo cambios en el defecto de perfusión en épocas tempranas, ni se presentaron complicaciones relacionadas con el trasplante celular o la utilización del factor estimulante de colonias de granulocito-macrófago.


Assuntos
Medula Óssea , Infarto do Miocárdio , Células-Tronco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA