bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stent fracture associated with drug‐eluting stents: Clinical characteristics and implications
Authors: Lee Michael S. , Jurewitz Daniel , Aragon Joseph , Forrester James , Makkar Raj R. , Kar Saibal 
Published: December 2006

AbstractObjective: To evaluate the clinical characteristics and implications of stent fracture in drug‐eluting stents. Background: Approximately 2.5 million drug‐eluting stents are implanted every year worldwide. In 10 randomized controlled trials involving 2,602 patients, no incidence of stent fracture was recognized or reported. Methods: From April 2003 to December 2005, 2,728 patients underwent drug‐eluting stenting. The angiograms of all 530 patients who underwent repeat angiography were analyzed to identify the presence of stent fracture. We then documented the incidence of adverse events associated with drug‐eluting stent fracture and systematically analyzed the clinical, procedural, and structural factors, which might predispose to stent fracture. Results: Stent fracture was identified in 10 patients. None of these fractures were detectable at the time of stent placement. The median time interval from stent implantation to detection of fracture at repeat angiography was 226 days (range, 7–620 days). Adverse clinical outcomes associated with stent fracture occurred in 7 patients (6 patients had binary restenosis and 1 patient had stent thrombosis), all necessitating repeat intervention. Analysis of potential predisposing clinical, procedural, and structural factors revealed that 4 patients had excessive tortuosity in the proximal segment, and overlapping stents were used in 5 cases. All fractures occurred in sirolimus‐eluting stents. Conclusions: Stent fracture may represent a new potential mechanism of restenosis and stent thrombosis in drug‐eluting stents. Predisposing clinical and procedural factors may be vessel tortuosity and use of overlapping stents. The most important predisposing factor, however, may be stent structure, since all fractures occurred in sirolimus‐eluting stents. © 2006 Wiley‐Liss, Inc.
Simultaneous kissing stent technique to treat left main stem bifurcation disease
Authors: Morton Allison C. , Siotia Anjan , Arnold Nadine D. , Korgul Peter , Bowles John , Heppenstall James , Gunn Julian 
Published: December 2006

AbstractBackground: While several endovascular techniques have been developed for treating arterial bifurcation lesions, there is, as yet, no single, widely accepted technique for treating left main stem (LMS) bifurcation lesions with stents. The simultaneous kissing stent (SCS) technique seems particularly suited for such lesions. The authors describe a consecutive cohort of patients with LMS bifurcation stenosis treated with this technique and present mechanistic insights from a porcine model. Methods: Thirty consecutive patients with LMS bifurcation stenosis ± multivessel disease were treated with SCS technique using paclitaxel‐eluting stents. The technique involves simultaneous implantation of two stents (LMS‐LAD and LMS‐Cx) so that the proximal end of both stents lie at the same level in the body of LMS. Symptom status was recorded and follow‐up angiography was performed. In addition, four pigs underwent SCS implantation of the LMS and were studied by direct examination, histology, and scanning electron microscopy. Results: The patients' mean age was 63, 26 were elective and 19 were male. Paclitaxel‐eluting stents (Taxus™, Boston Scientific) were used. There was one in‐hospital death in a highly unstable patient. At 6‐month follow‐up angiography, two patients required target lesion revascularization. At 13 ± 3 month follow‐up, the remaining patients remain well, with no other major adverse cardiac events. The animals all survived with patent stents. SEM demonstrated full re‐endothelialization and histology showed a thin but complete neointima covering the stent struts. Conclusion: The SCS technique for treating LMS bifurcation disease with paclitaxel‐eluting stents is safe and feasible. Medium term clinical and angiographic results are good. An endothelium and a thin neointima cover the metal struts. © 2006 Wiley‐Liss, Inc.
Transcatheter closure of ischemic and post‐traumatic ventricular septal ruptures
Authors: Martinez Matthew W. , Mookadam Farouk , Sun Yinguang , Hagler Donald J. 
Published: December 2006

AbstractPost‐traumatic ventricular septal defects (VSD) can occur after acute MI or iatrogenically after invasive surgical procedures. Emergency surgery is associated with high perioperative mortality and postsurgical shunt in up to 20% of patients. Transcatheter closure (TCC) of post MI VSD may be an alternative that avoids the high risk of surgery. We report a lower mortality and morbidity than surgical closure in the post infarction VSD's even with a short interval between defect occurrence and percutaneous device placement. Furthermore, in patients with a failed or suboptimal surgical result adjunctive percutaneous closure may be beneficial and offers an alternative to redo VSD repair. Finally, in patients who suffer an unexpected traumatic VSD post surgical procedure, percutaneous closure offers an alternative with excellent results. © 2006 Wiley‐Liss, Inc.
Incidence and clinical impact of coronary stent fracture after sirolimus‐eluting stent implantation
Authors: Aoki Jiro , Nakazawa Gaku , Tanabe Kengo , Hoye Angela , Yamamoto Hirosada , Nakayama Tomohiro , Onuma Yoshinobu , Higashikuni Yasutomi , Otsuki Syuji , Yagishita Atsuhiko , Yachi Sen , Nakajima Hiroyoshi , Hara Kazuhiro 
Published: December 2006

AbstractBackground: Stent fracture is one of the possible causes of restenosis after sirolimus‐eluting stents (SES) implantation. The aim of our study was to evaluate the prevalence and clinical impact of coronary stent fracture after SES implantation. Methods: From our prospective institutional database, 280 patients were treated solely with SES from August 2004 to June 2005. Among the 280 patients, 256 patients with a total of 307 lesions underwent follow‐up angiography on an average of 240 days after the procedure. Results: Stent fractures were observed in eight (2.6%) lesions. Of the eight lesions with stent fracture, five were located in the right coronary artery (RCA), two in the saphenous vein (SV) graft, and one in the left anterior descending coronary artery. The stent fractures were all in the locations that served as hinges during vessel movement in the cardiac contraction cycle. Seven of the eight stent fractures were adjacent to the edge of previously implanted or overlapped stent. Significant multivariate predictors of stent fracture were SV graft location (Odds ratio 35.88; 95% confidence interval 2.73–471.6, P = 0.006), implanted stent length (Odds ratio 1.04; 95% confidence interval 1.01–1.07, P = 0.02), and RCA location (Odds ratio 10.00; 95% confidence interval 1.11–89.67, P = 0.04). In‐stent binary restenosis rate was 37.5% and target lesion repeat revascularization rate was 50.0% in patients with stent fracture. Conclusions: Stent fracture was likely to be affected by mechanical stress provoked by rigid structures and hinge points. Stent fracture might be associated with the high incidence of target lesion revascularization. © 2006 Wiley‐Liss, Inc.
Successful nonsurgical treatment of left main stem perforation by sacrifice of the LAD
Authors: Gamma Reto , Thomas Martyn R. 
Published: December 2006

AbstractWe report two cases of coronary artery disease treated percutaneously and including rotational atherectomy, in which the interventional procedure was complicated by left main coronary artery perforation. The management and outcome of this potentially fatal complication are discussed. © 2006 Wiley‐Liss, Inc.
Successful use of blunt microdissection catheter in a chronic total occlusion of a celiomesenteric artery
Authors: Ayers N.P. , Zacharias S.J. , Abu‐Fadel M.S. , Hennebry T.A. 
Published: December 2006

AbstractChronic mesenteric ischemia is often a disabling condition associated with intestinal angina, weight loss, and sitophobia (a morbid aversion of food). Significant stenosis of two of the three main arteries of the gut is usually required to produce symptoms. Surgical therapy has included reimplantation and bypass grafting, usually with synthetic conduits and occasionally endarterectomy. Newer techniques have made endovascular treatment an emerging modality in managing some of the difficult lesions in the mesenteric circulation that cause chronic mesenteric ischemia. We describe the first reported case of blunt microdissection using a Frontrunner XP® CTO Catheter (Lumend, Redwood City, CA) to successfully cross, subsequently wire and stent a four‐year‐old chronic total occlusions in a celiac trunk, which also gave origin to the superior mesenteric artery. © 2006 Wiley‐Liss, Inc.
Utility of three‐dimensional reconstruction of coronary angiography to guide percutaneous coronary intervention
Authors: Gollapudi Raghava R. , Valencia Rafael , Lee Steve S. , Wong Garrett B. , Teirstein Paul S. , Price Matthew J. 
Published: December 2006

AbstractObjective:The goal of this study was to determine whether three‐dimensional (3D) reconstruction of traditional coronary angiography could optimize the choice of drug‐eluting stent (DES) length and number during percutaneous coronary intervention (PCI). Background: Coronary angiography is subject to significant foreshortening artifact that limits the ability of the operator to accurately determine lesion length. Methods: The angiographic images of the target vessels of consecutive PCI procedures were postprocessed using a 3D reconstruction algorithm. The appropriate length and optimal number of DES to span each target lesion were calculated and compared with the number and length of DES actually chosen by the operator. Results: A total of 42 target vessels were analyzed, and 3D reconstruction was successful in 38/42 (90.5%) of cases. The results of 3D analysis would have changed operator decision making in six cases (16%): in four cases, the stent chosen by the operator was too short requiring an additional DES; in two cases, the chosen DES was too long and exchanged for a shorter one. In each of these six cases, 3D analysis would have determined the correct stent length prior to stent selection. The optimal stent number derived by 3D reconstruction was significantly less than the actual number of stents per lesion used by the operator (1.31 ± 0.47 versus 1.54 ± 0.68, P = 0.01), and the optimal stent length trended less than the actual stented length (27.5 ± 12.8 mm versus 28.7 ± 14.7 mm, P = 0.23). Conclusions: 3D reconstruction algorithm of standard coronary angiography is a promising technique to improve DES utilization during PCI. © 2006 Wiley‐Liss, Inc.
One‐year results of unprotected left main disease treatment with paclitaxel‐eluting stents: Results of a multicenter registry
Authors: Sanmartin Marcelo , Baz Jose Antonio , Lozano Iñigo , de la Torre Jose Maria , Hernandez Jose Maria , Bordes Pascual , Mainar Vicente , Mauri Josepa , Iñiguez Andrés 
Published: December 2006

AbstractBackground: Preliminary data suggest that drug‐eluting stents might have a role in selected cases of unprotected left main stenosis (ULMS). The purpose of this study was to determine the rates of death, myocardial infarction, and repeated revascularization in a multicenter, prospective series of patients with ULMS treated with paclitaxel‐eluting stents. Methods: A prospective registry was initiated in March 2003 through December 2004 in five tertiary centers including all patients with a significant (>50%) stenosis in ULMS treated with at least one paclitaxel‐eluting stent. There were no clinical or angiographic exclusion criteria. Clinical follow‐up was obtained at 6 and 12 months. Results: A total of 100 patients were included. Mean age was 67.6 ± 11.4 years and 36% were diabetics. Distal left main was affected in 53% of patients. Implantation of two stents was required in only 15%. Angiographic success was achieved in all cases. Significant periprocedural CK‐MB elevation occurred in 5 patients and there was 1 intraprocedural death. At a median 9 months follow‐up, cardiac death occurred in 7%, the majority of which (4%) in patients with ST‐elevation myocardial infarction and cardiogenic shock before stent implantation. Only 3 patients (3%) required repeated target‐vessel revascularization, all repeated angioplasty procedures. Conclusion: Percutaneous treatment of unprotected left main lesions with paclitaxel‐eluting stents is associated with acceptable mid‐term results in selected patients, with very low rates of repeated revascularization. © 2006 Wiley‐Liss, Inc.
Hemodynamic improvement is faster after percutaneous ASD closure than after surgery
Authors: Eerola Anneli , Pihkala Jaana I. , Boldt Talvikki , Mattila Ilkka P. , Poutanen Tuija , Jokinen Eero 
Published: December 2006

AbstractObjectives: Hemodynamic effects of surgical and percutaneous closure of atrial septal defect (ASD) were evaluated. Background: ASD causes volume overload of right ventricle (RV) and is associated with distortion and dysfunction of left ventricle (LV). The amount and timing of hemodynamic changes after ASD closure are not well known. Methods: The study group consisted of 7 children treated surgically and 17 treated in the catheterization laboratory. In the control group, there were 51 healthy children. RV size and LV end‐diastolic and systolic dimensions, volumes, and function were examined by two‐ and three‐ dimensional echocardiography and serum concentrations of natriuretic peptides measured prior to ASD closure, and 1, 6, and 12 months thereafter. Results: In all children with ASD, during the 1‐year follow‐up, the z score of RV end‐diastolic diameter decreased from a median 5.00 SD to 2.25 SD (P < 0.001). Dilatation of RV did not resolve entirely during 1‐year follow‐up in either treatment group. End‐diastolic LV diameter increased from −1.50 to −0.50 SD (P < 0.001). LV size increased slower in the surgical subgroup but reached control levels in both groups. Concentrations of natriuretic peptides increased during the first month after ASD closure and normalized thereafter in patients treated percutaneously but remained higher than in controls in patients treated surgically. Conclusions: During 1‐year follow‐up after ASD closure, RV size decreases but does not normalize in all patients. The size of the LV normalizes after ASD closure but the increase in LV size is slower in patients treated surgically. Serum levels of ANPN and proBNP are elevated prior to ASD closure but decrease thereafter to control levels in patients treated with the percutaneous technique but not in those treated surgically. © 2006 Wiley‐Liss, Inc.
Thrombus predicts ischemic complications during percutaneous coronary intervention in saphenous vein grafts: Results from TARGET (do tirofiban and reopro give similar efficacy trial?)
Authors: Kalyanasundaram Arun , Blankenship James C. , Berger Peter , Herrmann Howard , McClure Rick , Moliterno David 
Published: December 2006

AbstractBackground: Saphenous vein graft (SVG) percutaneous coronary intervention (PCI) carries a high risk of ischemic complications. However, there are scant recent data to identify which SVG lesions carry particularly high risk in recent years. We studied demographic and angiographic factors associated with ischemic complications after SVG PCI without distal protection in the TARGET (do tirofiban and reopro give similar efficacy trial?) study. Methods: TARGET was a multicenter double‐dummy, double‐blinded study randomizing 4,809 PCI patients to tirofiban or abciximab. Of these, 254 patients underwent PCI involving an SVG lesion. The primary endpoint of this analysis was major adverse cardiac events (MACEs) at 30 days, including death, nonfatal myocardial infarction (MI), and urgent target vessel revascularization. Results: No demographic characteristic was associated with 30‐day MACE. Lesion length > 20 mm (odds ratio [OR] = 2.7, P = 0.03), thrombus (OR = 3.9, P = 0.003), eccentricity (P = 0.001), thrombolysis in myocardial infarction flow < 3 postprocedure (OR = 5.6, P = 0.037), and >1 target lesion (OR = 2.5, P = 0.035) were univariate variables associated with 30‐day MACE. Multivariate analysis associated only thrombus (OR = 3.8, P = 0.015) with 30‐day MACE. No difference in outcomes was noted between patients receiving abciximab and tirofiban. SVG patients had lesser angiographic success (95.6% vs. 98%, P = 0.04) and increased 30‐day Q‐wave MI (2.5% vs. 0.9%, P = 0.039) compared with non‐SVG patients, but a similar incidence of death (0% vs. 0.4%), non‐Q‐MI (5.9% vs. 4.5%), and target vessel revascularization (0.5% vs. 1%). Conclusion: In the era of routine stenting and GpIIb/IIIa inhibitors, thrombus is the angiographic characteristic most closely associated with adverse outcomes of SVG PCI © 2006 Wiley‐Liss, Inc.
Using fuzzy controllers as adaptive procedures in the finite element method
Authors: Silva R. S. , Almeida R. C. 
Published: December 2006

AbstractA general framework is developed to control simulation parameters that appear in finite element models in order to improve accuracy and efficiency. This approach is based on fuzzy logic that allows the expert knowledge to be taken into account on the controller design and avoids the requirement of defining a transfer function. A new feedback fuzzy controller (FC) is developed to tune the cores of the fuzzy set, producing an adaptive fuzzy controller (AFC). The designed AFC is applied to control the choice of the preconditioner to be used in an iterative solver. Its learning capability yielded a flexible controller, that can adaptively adjust the control parameters with the system changes. This methodology is also combined with a FC to drive the selection of the time step size. Numerical experiments are performed to demonstrate the performance of this novel feedback FC and its adaptive structure. Copyright © 2006 John Wiley & Sons, Ltd.
DQEM analysis of out‐of‐plane deflection of non‐prismatic curved beam structures considering the effect of shear deformation
Authors: Chen Chang‐New 
Published: December 2006

AbstractThe development of differential quadrature element method (DQEM) out‐of‐plane deflection analysis model of curved non‐prismatic beam structures considering the effect of shear deformation was carried out. The DQEM uses the differential quadrature (DQ) to discretize the governing differential equation defined on each element, the transition conditions defined on the inter‐element boundary of two adjacent elements and the boundary conditions of the beam. Numerical results solved by the developed numerical algorithm are presented. The convergence of the developed DQEM analysis model is efficient. Copyright © 2006 John Wiley & Sons, Ltd.
L∞ variational problems and weak KAM theory
Authors: Yu Yifeng 
Published: December 2006

AbstractIn the first part of this paper, we extend several results in Crandall, Evans, and Gariepy [11] and Crandall and Evans [10] to absolute minimizers of more general L∞ functionals. In the second part, we present some interesting connections between L∞ variational problems and weak KAM theory. As an application, we will advance the main result in Fathi and Siconolfi [17], i.e, the existence of a C1 subsolution of the Hamilton‐Jacobi equation. Moreover, we will propose a possible approximation of the projected Aubrey set by a variational approach that was first used by Evans in [14]. © 2007 Wiley Periodicals, Inc.
PDEs for the Gaussian ensemble with external source and the Pearcey distribution
Authors: Adler Mark , van Moerbeke Pierre 
Published: December 2006

AbstractThe present paper studies a Gaussian Hermitian random matrix ensemble with external source, given by a fixed diagonal matrix with two eigenvalues ±a. As a first result, the probability that the eigenvalues of the ensemble belong to an interval E satisfies a fourth‐order PDE with quartic nonlinearity; the variables are the eigenvalue a and the boundary of E. This equation enables one to find a PDE for the Pearcey distribution. The latter describes the statistics of the eigenvalues near the closure of a gap, i.e., when the support of the equilibrium measure for large‐size random matrices has a gap that can be made to close. The Gaussian Hermitian random matrix ensemble with external source, described above, has this feature. The Pearcey distribution is shown to satisfy a fourth‐order PDE with cubic nonlinearity. This also gives the PDE for the transition probability of the Pearcey process, a limiting process associated with nonintersecting Brownian motions on ℝ. © 2006 Wiley Periodicals, Inc.
Initial specification of the epibranchial placode in zebrafish embryos depends on the fibroblast growth factor signal
Authors: Nikaido Masataka , Doi Kazunao , Shimizu Takashi , Hibi Masahiko , Kikuchi Yutaka , Yamasu Kyo 
Published: December 2006

AbstractIn vertebrates, cranial sensory ganglia are mainly derived from ectodermal placodes, which are focal thickenings at characteristic positions in the embryonic head. Here, we provide the first description of the early development of the epibranchial placode in zebrafish embryos using sox3 as a molecular marker. By the one‐somite stage, we saw a pair of single sox3‐expressing domains appear lateral to the future hindbrain. The sox3 domain, which is referred to here as the early lateral placode, is segregated during the early phase of segmentation to form a pax2a‐positive medial area and a pax2a‐negative lateral area. The medial area subsequently developed to form the otic placode, while the lateral area was further segregated along the anteroposterior axis, giving rise to four sox3‐positive subdomains by 26 hr postfertilization. Given their spatial relationship with the expression of the markers for the epibranchial ganglion, as well as their positions and temporal changes, we propose that these four domains correspond to the facial, glossopharyngeal, vagal, and posterior lateral line placodes in an anterior‐to‐posterior order. The expression of sox3 in the early lateral placode was absent in mutants lacking functional fgf8, while implantation of fibroblast growth factor (FGF) beads restored the sox3 expression. Using SU5402, which inhibits the FGF signal, we were able to demonstrate that formation of both the early lateral domains and later epibranchial placodes depends on the FGF signal operating at the beginning of somitogenesis. Together, these data provide evidence for the essential role of FGF signals in the development of the epibranchial placodes. Developmental Dynamics 236:564–571, 2007. © 2006 Wiley‐Liss, Inc.
Combinatorial expression patterns of heparan sulfate sulfotransferases in zebrafish: III. 2‐O‐sulfotransferase and C5‐epimerases
Authors: Cadwallader Adam B. , Yost H. Joseph 
Published: December 2006

AbstractHeparan sulfate (HS) is an unbranched chain of repetitive disaccharides, which specifically binds ligands when attached to the cell surface or secreted extracellularly. HS chains contain sulfated domains, termed the HS fine structure, which give HS specific binding affinities for extracellular ligands. HS 2‐O‐sulfotransferase (2‐OST) catalyzes the transfer of sulfate groups to the 2‐O position of uronic acid residues of HS. We report here the characterization and developmental expression patterns of 2‐OST in several tissues/organs throughout early zebrafish development, including early cleavage stages, eyes, somites, brain, internal organ primordial, and pectoral fin. The 2‐OST gene has spatially and temporally distinct expression, which is a surprise given the essential role of 2‐OST in HS fine structure formation. Furthermore, although 2‐OST and C5‐epimerase are predicted to be interdependent for protein translocation from the endoplasmic reticulum to the Golgi, their expression is not coordinately regulated during zebrafish development. Developmental Dynamics 236:581–586, 2007. © 2006 Wiley‐Liss, Inc.