Lege Artis Medicinae

[Examination of the parameters affecting restenosis using coronary stents]

TAKÁCS Tibor, BOGNÁR Eszter, DOBRÁNSZKY János

MARCH 20, 2010

Lege Artis Medicinae - 2010;20(03-04)

[Treatment of coronary artery stenoses has substantially changed; previous cardiac surgery methods have been replaced by percutaneous coronary interventions, especially coronary stent implantations. Nevertheless, stenonis can reoccur in the artery following stent implantation; this process is called in-stent restenosis. In the present study, we examined the technical characteristics of coronary stents that, if selected optimally, can reduce the frequency of in-stent restenoses. These characteristics include the technology used for the manufacturing of the stent, the stent’s structure, the area of its metal-covered surface, its strut profile and coating. In our study, we examined strut width and profile of ten coronary stents (AVE GFX, Express, Liberté, Multi-Link Zeta, Orbus R, Pro-Kinetic, Sanocor, Tecnic Carbostent, Tentaur, Tentaur-C). We measured strut’s width using an Olympus PMG3 metallurgical microscope, and studied changes of the Sanocor Stent’s strut thickness during the manufacturing process. Our results showed that the Sanocor Stent’s strut thickness was reduced during the manufacturing process.]

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[Chronic stress is associated with increased levels of cortisol and catecholamines as well as with an enhanced activity of the sympathico-sensory nervous system. These neuroendocrine events influence both directly and indirectly the lipid and glucose metabolism as well as inflammatory immune reactions. Stress effects directly cause vascular damage and atherosclerosis via the renin-angiotensin system (RAS). Besides RAS, activities of monocytes/macrophages and the sympathico-sensory nervous system lead to local cardiovascular inflammation and cell hypertrophy. Transactivation between G-protein coupled adrenoceptors and tyrosine kinase receptors as well as the switching between β1- and β2- adrenergic receptors play an important role in the development of cardiac hypertrophy and heart failure. In all chronic neuroendocrine diseases that are associated with increased activity of the sympathetic nervous system, the development of cardiovascular damages needs to be considered.]

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