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#31
17.11.2006, 05:16
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Цитата:
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#34
17.11.2006, 18:48
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#35
17.11.2006, 19:00
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#36
17.11.2006, 20:26
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Цитата:
Рекомендации к ангиографии при стабильной стенокардией приведены выше. Мне кажется можно ими пользоваться в большинстве случаяев. Цитата:
 Цитата:
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#37
17.11.2006, 22:32
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#38
18.11.2006, 02:53
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papadoctor одобрил(а): Дак это известно с прошлого века!
U'd be surprised how FEW people outside the cath lab actually KNOW this. If you take internists in the comunity, probably 1%, not more. If you take the general public, probably nobody. It almost looks like "THEY" dont want you to know this (a little conspiracy theory  )
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#39
18.11.2006, 03:54
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Немного в тему: результаты ОАТ показали, что уже спустя 3 дня после ОИМ (а не то, что при стабильной ИБС) выполнение PCI не имеет преимуществ перед мед. лечением (а быть может даже несет некоторый экстра-риск):
[Ссылки доступны только зарегистрированным пользователям ]
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#40
18.11.2006, 05:09
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Цитата:
Если читать предыдуший пост, складывается впечатление (особенно у врачей не знакомых с деталями) о полной бесполезности (а даже м.б. ненужности) коронарной интервенции при ОИМ спустя 3-е суток. Поосторожнее пжлста  P.S. более 20% (это каждый пятый) из группы консервативного лечения таки получили столь "нелюбимую" PCI с долей CABG 
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#41
18.11.2006, 05:31
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To AlexMD
Цитата:
 Откуда инфа? На ПРАКТИКЕ все не так оптимистично. Пример: пациент средних лет после АКШ, прошло два года и видим.... (ранее через год после АКШ было вмешательство на крупной ДВ - стоят два обычных стента, без рестеноза) Ну и что предложим пациенту... таблетки? повторно шунт (но куда) ? А что делать с молодыми пациентами? Тоже шунты?
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#42
18.11.2006, 07:38
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Зависит какие руки делают АКШ и какие ставят стенты! Не ЕВМ, но факт. В моей практике приблизительно 15-20% ре-опов и обычно светлый промежуток около 20 лет и подавляющее большинство из них имеет сохранённую систолическую функцию.Так же к сожалению значительный процент пациентов которые в течении короткого промежутка времени получили 3-4 стента и EF за это время с 60 дошла до 20.
ИМХО результаты по применению DES в значительной степени отражают желание кардиологов застентировать всё чего не попадя, не взирая на анатомию и характер поражения артерий. Плюс эначительный процент пациентов с прокоагулянтными "дискразиями" диагностируются пост фактум. ПС. Ещё раз оговорюсь, что это частное мнение анестезиолога, который много ночей провёл вне дома из-за cath-lab catastrophies.
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#43
18.11.2006, 07:45
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Цитата:
Кроме того после неосложненного инфаркта через 4-6 недель делается стресс-тест и если он положительный - cath и далее по алгоритму.
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#44
19.11.2006, 08:04
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Они не спят... (Медтроник)
Current drug-eluting stents (DES) do not meet all the requirements of physicians who deal with the most challenging clinical cases, such as patients with diabetes. This newest DES innovation from Medtronic (NYSE: MDT) leverages the strengths of the Endeavor stent and introduces a proprietary, new biocompatible polymer called BioLinx. This new polymer is designed to help match the duration of drug delivery with the longer healing duration often experienced by patients with complex medical conditions. BioLinx is different than other polymers in that its outer surface is hydrophilic (water friendly), which leads to high biocompatibility with the body, while the interior of the polymer is hydrophobic, which helps to precisely control the drug release.
The RESOLUTE trial enrolled 130 patients at 12 clinical centers in Australia and New Zealand, with a primary endpoint of late lumen loss (in-stent) at nine months and customary angiographic, intravascular ultrasound (IVUS) and clinical secondary endpoints. Thirty-day clinical results for 130 patients showed a Major Adverse Cardiac Event (MACE) rate of 3.8 percent, with zero Target Lesion Revascularization (TLR) and no stent thrombosis. In 30 patients with four-month angiographic follow-up, in-stent late loss was 0.12 mm and in-segment late loss was 0.05 mm. Both in-stent and in-segment binary restenosis were zero, and intravascular ultrasound (IVUS) results showed neointimal volume obstruction of 2.2 percent at four months. Stent device and lesion success was 100 percent, which means that physicians were successful in placing the assigned stents in the proper location with few complications. "Current drug-eluting stents have significantly reduced restenosis rates for most patients, but there are still many unmet clinical needs," said Scott Ward, president of Medtronic's vascular business. "Patients with diabetes, diffuse and multi-vessel disease, chronic total occlusions and other challenging medical conditions still have lower than desired clinical outcomes and require better treatment options. We've combined our proprietary new BioLinx polymer with zotarolimus to address the specific healing needs of these patients. Endeavor RESOLUTE may provide physicians with a new clinical option for the treatment of their most challenging patients with coronary artery disease."
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#45
19.11.2006, 08:06
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Они не спят... (Эббот)
Early clinical results from Abbott's ongoing ABSORB clinical trial, the world's first study to evaluate the safety and performance of a fully bioabsorbable drug-eluting stent platform for the treatment of coronary artery disease in humans, were presented today during the 18th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in Washington, D.C. Initial results for the first 30 patients in the trial demonstrated no MACE (Major Adverse Cardiac Events, such as heart attack) and no stent thrombosis at 30 days for patients who received a bioabsorbable everolimus-eluting stent.
Abbott's bioabsorbable drug-eluting stent is made of polylactic acid, which is designed to be fully absorbed and slowly metabolized by the coronary artery. The everolimus-coated stent will release the drug into the artery and then slowly absorb over time. The goal is to leave a healed natural vessel behind. "We are highly encouraged by these initial results from the ABSORB trial," said John Ormiston, M.D., Auckland City Hospital, New Zealand, and co- principal investigator of the study. "We are eager to explore Abbott's bioabsorbable technology as a potential clinical option for the treatment of coronary artery disease." The ABSORB trial is designed to assess safety and performance of Abbott's bioabsorbable everolimus-eluting stent in the treatment of patients with single de novo, native coronary artery disease or untreated lesions. Everolimus has been shown to reduce tissue growth in the coronary vessels following stent implantation. "Bioabsorbable technology holds great potential for many vascular applications," said John M. Capek, Ph.D., president, Cardiac Therapies, Abbott Vascular. "We intend to use the data from the ABSORB trial to study and develop therapies that can better serve physicians and their patient. Abbott's support of this study further demonstrates the depth of our vascular pipeline and illustrates our commitment to investing in future technologies." The ABSORB trial is a prospective, non-randomized (open label) study and has been designed to enroll up to 60 patients in Belgium, Denmark, France, New Zealand, Poland and The Netherlands. The key endpoints of the study include an assessment of the safety (MACE and stent thrombosis rate) at 30, 180, and 270 days, with an annual follow-up for up to five years, and successful deployment of the bioabsorbable drug-eluting stent. Additional endpoints of the study include angiography and intravascular ultrasound (IVUS) follow-up at 180 days and two years. Даешь рассасывающиеся стенты! 
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Линейный вид
