Essentials of Restenosis

For the Interventional Cardiologist
1. Auflage 2007
ISBN: 978-1-59745-001-0
Verlag: Humana Press
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 458 Seiten

Leading interventional cardiologists, including Patrick Serruys, provide the gold-standard reference on the treatment of restenosis for interventional cardiologists. Dr. Serruys, who pioneered the use of drug-eluting stents, and other pioneers in the field, cover everything from non-invasive imaging, to eluting stents, to brachytherapy through to the latest molecular biology-based treatments including antisense, stem cells and gene therapy.

Autoren/Hrsg.

Inhaltsverzeichnis

1;PREFACE;6
2;CONTENTS;7
3;CONTRIBUTORS;9
4;I PATHOPHYSIOLOGY AND DIAGNOSIS;30
4.1;Unraveling the Complex Process of Restenosis From Bench to Bedside;31
4.1.1;INTRODUCTION;31
4.2;Epidemiology and Pathogenesis of Restenosis;34
4.2.1;SCOPE AND EPIDEMIOLOGY OF RESTENOSIS;34
4.2.2;PATHOGENESIS OF RESTENOSIS;37
4.2.3;DISCUSSION;49
4.2.4;REFERENCES;49
4.3;Clinical Presentation of Restenosis;56
4.3.1;INTRODUCTION;56
4.3.2;TIMING OF RESTENOSIS;57
4.3.3;SILENT ISCHEMIA;58
4.3.4;CHEST PAIN;63
4.3.5;MI AND DEATH;67
4.3.6;CONCLUSIONS;68
4.3.7;REFERENCES;69
4.4;Pathological Anatomy of Restenosis;74
4.4.1;INTRODUCTION;74
4.4.2;BARE METAL STENTS AND VASCULAR HEALING IN ANIMAL MODELS;75
4.4.3;HEALING IN HUMAN STENTED CORONARY ARTERIES;75
4.4.4;SMC PROLIFERATION;77
4.4.5;THE EXTRACELLULAR MATRIX;77
4.4.6;DIFFERENCE IN ARTERIAL HEALING BETWEEN HUMANS AND ANIMALS;78
4.4.7;INFLAMMATION AND RESTENOSIS: THE RELATIONSHIP TO VESSEL INJURY AND PLAQUE TYPE;80
4.4.8;ANGIOGENESIS AND NEOINTIMAL FORMATION AND INFLAMMATION;81
4.4.9;PLAQUE CHARACTERISTICS AND RESTENOSIS;82
4.4.10;THE INFLUENCE OF DIABETES ON RESTENOSIS;82
4.4.11;DES AND HEALING IN PRECLINICAL STUDIES;83
4.4.12;REFERENCES;83
4.5;The Influence of Shear Stress on Restenosis;86
4.5.1;SHEAR STRESS AND VASCULAR (PATHO) BIOLOGY;86
4.5.2;SHEAR STRESS IN PATIENTS;89
4.5.3;SHEAR STRESS AND RESTENOSIS AFTER BALLOON ANGIOPLASTY;91
4.5.4;SHEAR STRESS AND RESTENOSIS AFTER STENTING;94
4.5.5;CONCLUSIONS;105
4.5.6;REFERENCES;105
4.6;The Immune System in the Pathogenesis of Vascular Proliferative Disease;111
4.6.1;INTRODUCTION: THE INTERVENTIONAL CARDIOLOGIST AND MODERN IMMUNOLOGY;112
4.6.2;ATHEROSCLEROSIS AS AN INFLAMMATORY DISEASE;112
4.6.3;IS THE IMMUNE SYSTEM INVOLVED IN VASCULAR DISEASE?;114
4.6.4;SELECTED IMMUNE SYSTEM BASICS;115
4.6.5;PREVAILING DOGMA: ACTIVATION OF PRIMARY LYMPHOCYTES IN THE LYMPH NODE;132
4.6.6;PLAQUE TYPE AND VASCULAR-ASSOCIATED LYMPHOID TISSUE;134
4.6.7;EVIDENCE FROM ANIMAL MODELS FOR IMMUNE SYSTEM INVOLVEMENT;135
4.6.8;ROLE OF NONPATHOGENIC MICROBES AND INFECTIONS;135
4.6.9;MECHANISMS BY WHICH MICROBES AND INFECTION MAY AFFECT ATHEROSCLEROSIS;141
4.6.10;RECIPROCAL INTERACTIONS BETWEEN INFLAMMATION AND LIPID METABOLISM;143
4.6.11;OPTIONS FOR INTERVENTION AND RESEARCH;147
4.6.12;ACKNOWLEDGMENTS;148
4.6.13;KEY POINTS ON IMMUNITY AND LIPIDS;148
4.6.14;KEY POINTS ON PLAQUE ASPECTS;148
4.6.15;KEY POINTS ON MAIN CELLULAR PLAYERS AND ANTIGENS INVOLVED IN ATHEROGENESIS;148
4.6.16;ABBREVIATIONS;149
4.6.17;REFERENCES;150
4.7;Animal Restenosis Models;157
4.7.1;INTRODUCTION;157
4.7.2;ANIMAL RESTENOSIS MODELS IN COMMON USE;157
4.7.3;IS THERE A SPECIES-SPECIFIC ARTERIAL RESPONSE TO ARTERIAL INJURY?;161
4.7.4;DRUG STUDIES;165
4.7.5;CONCLUSIONS: THE IDEAL STUDY;170
4.7.6;REFERENCES;171
5;II GENETIC BASIS OF RESTENOSIS;177
5.1;The Genomics of Restenosis;178
5.1.1;INTRODUCTION;178
5.1.2;AN INTRODUCTION TO GENOMICS;179
5.1.3;GENOMIC TOOLS;180
5.1.4;APPLICATION OF GENOMICS TO RESTENOSIS;185
5.1.5;EXISTING DATA WITHIN THE FIELD OF RESTENOSIS GENOMICS;186
5.1.6;FUTURE DIRECTIONS;187
5.1.7;SUMMARY;187
5.1.8;GLOSSARY;188
5.1.9;REFERENCES;189
5.2;Gene-Expression Profiling and Restenosis;191
5.2.1;INTRODUCTION;191
5.2.2;TECHNICAL APPROACH TO GENE-EXPRESSION PROFILING;192
5.2.3;PCR-BASED APPROACHES;192
5.2.4;ELUCIDATION OF MECHANISMS OF RESTENOSIS;193
5.2.5;IN VITRO EXPERIMENTS;194
5.2.6;ANIMAL EXPERIMENTS;194
5.2.7;STUDIES IN PATIENTS;194
5.2.8;THERAPEUTIC DEVELOPMENT;195
5.2.9;PERSPECTIVES;196
5.2.10;REFERENCES;196
5.3;Proteomics and Restenosis;198
5.3.1;INTRODUCTION;198
5.3.2;PROTEOMICS;199
5.3.3;METHODS;200
5.3.4;PROTEOMICS IN RESTENOSIS;204
5.3.5;SUMMARY;204
5.3.6;REFERENCES;205
5.4;Contribution of Circulating Progenitor Cells to Vascular Repair and Lesion Formation;207
5.4.1;INTRODUCTION;207
5.4.2;CONTRIBUTION OF SMCS TO VASCULAR LESIONS;207
5.4.3;CONTRIBUTION OF BONE MARROW CELLS TO VASCULAR LESIONS;209
5.4.4;THERAPEUTIC STRATEGIES TARGETING CIRCULATING VASCULAR PROGENITOR CELLS;214
5.4.5;CONCLUSIONS;216
5.4.6;REFERENCES;216
5.5;Cell Cycle Regulators and Vascular Proliferative Diseases;220
5.5.1;INTRODUCTION;220
5.5.2;ATHEROSCLEROSIS;221
5.5.3;VSMC HYPERPLASIA;221
5.5.4;STEM CELLS;222
5.5.5;CELL CYCLE;224
5.5.6;CELL CYCLE REGULATION AND VSMC HYPERPLASIA;228
5.5.7;MOLECULAR TARGETS FOR VASCULAR THERAPIES;229
5.5.8;REFERENCES;229
5.6;Arterial Remodeling;234
5.6.1;INTRODUCTION;234
5.6.2;ARTERIAL REMODELING AFTER ANGIOPLASTY;234
5.6.3;ARTERIAL REMODELING AND ECM TURNOVER;236
5.6.4;ARTERIAL REMODELING AND PROTEASE ACTIVITY;237
5.6.5;ARTERIAL REMODELING: A ROLE FOR IMMUNITY?;238
5.6.6;ARTERIAL REMODELING: INTERVENTIONS;239
5.6.7;ARTERIAL REMODELING: CONCLUSIONS;241
5.6.8;REFERENCES;241
5.7;The Role of eNOS in Vascular Diseases;247
5.7.1;THREE ISOFORMS OF NOS;247
5.7.2;SYNTHESIS OF NO;248
5.7.3;REGULATION OF NO PRODUCTION;248
5.7.4;MEASUREMENT OF NO PRODUCTION;250
5.7.5;MECHANISMS OF DECREASED NO BIOAVAILABILITY;250
5.7.6;ROLE OF NO IN PATHOGENESIS OF VASCULAR DISEASES;252
5.7.7;KEY NOTES;259
5.7.8;REFERENCES;259
6;III DIAGNOSIS OF RESTENOSIS;264
6.1;The Use of Pressure Gradient in the Diagnosis of Restenosis;265
6.1.1;INTRODUCTION;265
6.1.2;DEFINITION OF FRACTIONAL FLOW RESERVE;266
6.1.3;CLINICAL VALIDATION OF FRACTIONAL FLOW RESERVE;267
6.1.4;PRACTICAL SET-UP OF PRESSURE MEASUREMENTS IN THE CATHETERIZATION LABORATORY;268
6.1.5;APPLICATION OF PRESSURE MEASUREMENTS IN THE DIAGNOSIS OF RESTENOSIS;269
6.1.6;COST-EFFECTIVENESS OF FRACTIONAL FLOW RESERVE;269
6.1.7;LIMITATIONS;270
6.1.8;CONCLUSIONS;272
6.1.9;REFERENCES;273
6.2;The Use of Radio Isotopes in the Diagnosis of Vascular Proliferative Disease;275
6.2.1;INTRODUCTION;275
6.2.2;MPI WITH RADIONUCLIDES;276
6.2.3;IMAGING THE VASCULAR PROLIFERATIVE DISEASE PROCESS;278
6.2.4;MPI IN PATIENTS AFTER PCI;280
6.2.5;SUMMARY STATEMENTS;290
6.2.6;CONCLUSIONS;290
6.2.7;REFERENCES;291
6.3;Magnetic Resonance Imaging for Restenosis;294
6.3.1;INTRODUCTION;294
6.3.2;SAFETY OF STENTS;294
6.3.3;STENT RELATED ARTEFACTS;295
6.3.4;MR FLOW MEASUREMENTS;296
6.3.5;MR COMPATIBLE (TRANSPARENT) STENTS;296
6.3.6;SUMMARY;300
6.3.7;REFERENCES;300
6.4;Coronary Imaging With Multislice Spiral Computed Tomography;303
6.4.1;INTRODUCTION;303
6.4.2;CARDIAC CT;304
6.4.3;DETECTION OF CORONARY STENOSIS;308
6.4.4;PLAQUE IMAGING;309
6.4.5;IMAGING OF CORONARY ARTERIES WITH STENTS;309
6.4.6;CONCLUSION;312
6.4.7;REFERENCES;312
7;IV THERAPY OF RESTENOSIS;314
7.1;Pharmacotherapy of Restenosis;315
7.1.1;INTRODUCTION;315
7.1.2;PHARMACOTHERAPY FOR RESTENOSIS AFTER BALLOON ANGIOPLASTY: THE EARLIER STUDIES;315
7.1.3;PHARMACOTHERAPY FOR RESTENOSIS AFTER BALLOON ANGIOPLASTY: THE LATER STUDIES;316
7.1.4;PHARMACOLOGICAL TREATMENT TO PREVENT IN- STENT RESTENOSIS;317
7.1.5;PHARMACOLOGICAL TREATMENT FOR PREVENTION OF MAJOR ADVERSE EVENTS AFTER STENT- IMPLANTATION;317
7.1.6;REFERENCES;319
7.2;Brachytherapy;321
7.2.1;INTRODUCTION;321
7.2.2;THE CLINICAL TRIALS;322
7.2.3;TRIALS OF;323
7.2.4;RADIATION;323
7.2.5;WRIST SERIES;327
7.2.6;TRIALS;330
7.2.7;CLINICAL TRIALS OF;331
7.2.8;RADIATION;331
7.2.9;CLINICAL TRIALS WITH RADIOACTIVE EMITTING STENTS;341
7.2.10;CONTROVERSIES IN VASCULAR BRACHYTHERAPY;342
7.2.11;KEY POINTS/CONCLUSIONS;343
7.2.12;REFERENCES;343
7.3;Preclinical Data of Eluting Stents;347
7.3.1;INTRODUCTION;347
7.3.2;RESTENOSIS AFTER ANGIOPLASTY AND AFTER STENTING: TWO DIFFERENT MECHANISMS;348
7.3.3;PATHOPHYSIOLOGY OF IN-STENT RESTENOSIS;349
7.3.4;ANIMAL MODELS;351
7.3.5;COMPARISON OF VASCULAR HEALING IN ANIMALS AND HUMANS;352
7.3.6;DRUG-ELUTING STENTS;352
7.3.7;DES BIOCOMPATIBLE MATERIALS;354
7.3.8;DES WITH PROHEALING AGENTS;354
7.3.9;DES WITH CORTICOSTEROIDS;355
7.3.10;DES WITH ANTIMITOTIC AGENTS;355
7.3.11;REFERENCES;362
7.4;Clinical Data of Eluting Stents;367
7.4.1;INTRODUCTION;367
7.4.2;STENTS ELUTING ANTI-INFLAMMATORY AGENTS;368
7.4.3;STENTS ELUTING IMMUNOSUPPRESSIVE AGENTS;368
7.4.4;SIROLIMUS-ELUTING STENTS;368
7.4.5;SIROLIMUS ANALOGS ELUTING STENTS;373
7.4.6;TACROLIMUS-ELUTING STENTS;373
7.4.7;MYCOPHENOLIC ACID-ELUTING STENT;373
7.4.8;STENTS ELUTING ANTIPROLIFERATIVE AGENTS;374
7.4.9;PACLITAXEL-ELUTING STENTS;374
7.4.10;POLYMER-BASED TAXOL-ELUTING STENTS;374
7.4.11;NONPOLYMER-BASED TAXOL-ELUTING STENTS;375
7.4.12;ACTINOMYCIN-ELUTING STENTS;376
7.4.13;ANGIOPEPTIN-ELUTING STENTS;376
7.4.14;STENT-ELUTING EXTRACELLULAR MATRIX MODULATORS;376
7.4.15;PROHEALING ELUTING STENTS;376
7.4.16;NITRIC OXIDE-ELUTING STENTS;377
7.4.17;ESTRADIOL-ELUTING STENTS;377
7.4.18;REAL WORLD CLINICAL DATA;377
7.4.19;STENT DEPLOYMENT TECHNIQUE;378
7.4.20;FUTURE DES INDICATIONS;379
7.4.21;REFERENCES;380
7.5;Biodegradable Stents;382
7.5.1;THE ROLE OF STENTS IN PERCUTANEOUS CORONARY INTERVENTION;382
7.5.2;HISTORY OF THE BIODEGRADABLE STENT;383
7.5.3;HISTORY OF THE IGAKI–TAMAI STENT;383
7.5.4;APPLICATION OF THE IGAKI–TAMAI STENT TO HUMAN CORONARY ARTERIES;384
7.5.5;TIME-COURSE OF IVUS FINDINGS AFTER IMPLANTATION OF THE IGAKI – TAMAI STENT;387
7.5.6;CONCLUSIONS;388
7.5.7;REFERENCES;388
8;V BIOTECHNOLOGY IN THE TREATMENT OF RESTENOSIS;389
8.1;Vascular Gene Therapy;390
8.1.1;INTRODUCTION;390
8.1.2;VASCULAR GENE-TRANSFER VECTORS;392
8.1.3;NONVIRAL VECTORS;393
8.1.4;VIRAL VECTORS;394
8.1.5;PROMOTERS FOR VASCULAR GENE TRANSFER;396
8.1.6;THE INTERFACE OF VECTORS, PROMOTERS, AND THE FUTURE;401
8.1.7;REFERENCES;403
8.2;Antisense and ODN Transcription Factors in the Treatment of Vascular Proliferative Disease;406
8.2.1;INTRODUCTION;406
8.2.2;GENE THERAPY OF INTIMAL HYPERPLASIA;407
8.2.3;RATIONALE FOR USING ANTISENSE OLIGONUCLEOTIDES IN THE TREATMENT OF INTIMAL HYPERPLASIA;408
8.2.4;EFFICACY OF ANTISENSE OLIGONUCLEOTIDES IN THE INHIBITION OF SMC PROLIFERATION AND THE PREVENTION OF RESTENOSIS;409
8.2.5;DELIVERY SYSTEMS FOR ANTISENSE OLIGONUCLEOTIDES;410
8.2.6;CLINICAL IMPLICATIONS AND FIRST EXPERIENCE OF ANTISENSE THERAPY IN THE TREATMENT OF VASCULAR PROLIFERATIVE DISEASE;411
8.2.7;CONCLUSION;414
8.2.8;ACKNOWLEDGMENTS;414
8.2.9;REFERENCES;414
8.3;Cell Cycle Approaches to the Treatment of In- Stent Restenosis;418
8.3.1;INTRODUCTION;418
8.3.2;THE CELL CYCLE: CYCLINS, CDKS, AND CDK INHIBITORS;419
8.3.3;p27Kip1 AND p21Cip1 FUNCTION;420
8.3.4;THE CDKS AND CKIS IN VASCULAR REMODELING;421
8.3.5;CLINICAL APPLICATION OF THE CKIS;422
8.3.6;REFERENCES;426
8.4;Local Gene and Cell Delivery Devices;429
8.4.1;INTRODUCTION;429
8.4.2;LOCAL DELIVERY DEVICES;432
8.4.3;DOUBLE BALLOON CATHETER;433
8.4.4;DISPTACH;434
8.4.5;CATHETER;434
8.4.6;POROUS AND MICROPOROUS BALLOONS;435
8.4.7;CHANNELED BALLOON CATHETER;438
8.4.8;INFUSASLEEVE CATHETER;438
8.4.9;HYDRO-GEL ANGIOPLASTY BALLOON;439
8.4.10;INFILTRATOR CATHETER;441
8.4.11;IONTOPHORETIC BALLOON;443
8.4.12;STENTS;444
8.4.13;COMPARISONS OF LOCAL DELIVERY DEVICES;445
8.4.14;CONCLUSION;448
8.4.15;REFERENCES;448
9;INDEX;453