RESUMEN

Although the importance of the retrieval of an optional inferior vena cava filter (o-IVCF) has gained attention because of the awareness of a high complication rate with long indwelling time, the o-IVCF retrieval rate remains low. The advanced retrieval technique of o-IVCF may increase the retrieval rate, which in turn diminishes future adverse events. Through two cases, we describe how to perform the novel approach "bidirectional sling technique with biopsy forceps." This technique will improve the retrieval rate in patients following the failure by conventional retrieval technique.

RESUMEN

BACKGROUND: It is recommended to remove retrievable inferior vena cava filters (r-IVCFs) when they are no longer needed because their presence may give rise to serious complications related to prolonged placement of the filter. An advanced filter retrieval technique may help improve the retrieval rate.Methods and Results:107 consecutive patients (mean age; 61±18 years, male 53%) in whom r-IVCF retrieval was attempted were prospectively enrolled between April 2012 and December 2018. The frequently used advanced techniques were sling technique and biopsy forceps dissection technique. Retrieval success was 75% with standard retrieval technique alone; however, the overall retrieval success rate improved to 98% with advanced techniques. We observed few serious complications related to the retrieval procedure. Logistic multivariate analysis identified prolonged indwelling time (P=0.0011) and embedded hook in the caval wall (P=0.0114) as independent predictors, and the cutoff value for the indwelling time for requirement of advanced technique was 80 days. CONCLUSIONS: Advanced retrieval techniques helped improve the retrieval rate without serious complications. We may need to consider the referral of patients to centers with expertise in advanced retrieval techniques when the indwelling time is >80 days, and pre-retrieval CT image shows a hook embedded in the vessel wall.

Asunto(s)

Remoción de Dispositivos , Filtros de Vena Cava , Adulto , Anciano , Remoción de Dispositivos/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Instrumentos Quirúrgicos , Resultado del Tratamiento , Filtros de Vena Cava/efectos adversos , Vena Cava Inferior

RESUMEN

Central venous occlusion (CVO) remains an unresolved issue in hemodialysis patients. We herein present an interesting case of a 42-year-old hemodialysis female patient with complete vision loss in the left eye, who was at high risk of losing vision in her right eye because of neovascular glaucoma (NVG). Computed tomography (CT) showed occlusion of the right internal jugular vein (IJV) just above the junction with the right innominate vein. From the configuration and location of the lesion, it was concluded the occlusion had been caused by venous valvular degeneration. Her NVG with progressive intraocular pressure (IOP) elevation was presumably attributed to the right IJV occlusion. The extra-rigid occlusive lesion was successfully penetrated by means of a Brockenbrough needle and subsequently implanted with a balloon-expandable stent. Intravascular ultrasound (IVUS) guidance allowed us to manipulate the Brockenbrough needle safely. After stent implantation, the right IOP declined dramatically, resulting in the preservation of her eyesight. .

RESUMEN

We report a case of a dialysis patient with severe aortic stenosis(AS) along with bilateral pheochromocytomas. A 52-year-old man presented with syncope and was diagnosed with severe AS. Although aortic valve replacement(AVR) was scheduled, bilateral pheochromocytomas were found during preoperative examination. There was a high possibility of developing hemodynamical crisis during AVR, and we planned to perform adrenalectomy prior to AVR. To avoid circulatory collapse just after adrenalectomy, balloon aortic valvuloplasty (BAV) was performed beforehand. Two weeks after the adrenalectomy, AVR was performed in a stable condition.

Asunto(s)

Neoplasias de las Glándulas Suprarrenales , Estenosis de la Válvula Aórtica , Valvuloplastia con Balón , Feocromocitoma , Válvula Aórtica , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Diálisis Renal , Resultado del Tratamiento

RESUMEN

A 65-year-old woman with type Ⅱ diabetes and unstable angina presented with chest pain due to in-stent restenosis. Her regular medication comprised an sodium-glucose co-transporter( SGLT) 2 inhibitor. Because of unstable hemodynamic status, semi-emergency coronary artery bypass grafting (CABG) was performed. Postoperatively, the cardiac and hemodynamic status stabilized, but there was progression of metabolic acidosis. Based on the presence of massive urinary ketone bodies without hyper glycosuria, the patient was diagnosed with euglycemic diabetic ketoacidosis( DKA) caused by an SGLT2 inhibitor. Ketoacidosis without elevated blood glucose( i.e., euglycemic DKA) has been reported to be associated with intake of an SGLT2 inhibitor, which promoted glucose excretion in the urine. Our patient developed euglycemic DKA due to the progression of myocardial ischemia and surgical stress. Guidelines in other countries have stipulated that SGLT2 inhibitor should be stopped 24 hours preoperatively. In our case, euglycemic DKA occurred even when the SGLT2 inhibitor was stopped for more than 24 hours preoperatively. Further studies on the withdrawal of an SGLT2 inhibitor in the appropriate perioperative period are required.

Asunto(s)

Diabetes Mellitus Tipo 2 , Cetoacidosis Diabética , Anciano , Puente de Arteria Coronaria , Femenino , Glucosa , Humanos , Sodio , Inhibidores del Cotransportador de Sodio-Glucosa 2

Asunto(s)

Angioplastia Coronaria con Balón/métodos , Reestenosis Coronaria/cirugía , Humanos

RESUMEN

BACKGROUND: Chronic total occlusion (CTO) lesions are a challenging issue. When dealing with complex CTO lesions in patients undergoing percutaneous coronary intervention (PCI), it is important to evaluate not only the CTO lesion itself but also atherosclerotic lesions of the whole coronary artery tree. The utility of the SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Trial) score in patients with CTO undergoing PCI is unclear. METHODS: This retrospective study included 304 consecutive patients with CTO lesions who underwent PCI. Primary endpoints were procedural failure and major adverse cardiac events (MACE) within 30 days. The SYNTAX and J-CTO (Multicenter CTO Registry in Japan) scores were assessed before the procedures, and patients were divided into two groups according to SYNTAX criteria: high (> 22; n = 158) and low (≤ 22; n = 146) SYNTAX scores. RESULTS: Procedural success was achieved in 252 patients (82.9 %). Patients with a high SYNTAX score had significantly lower procedural success than those with a low SYNTAX score (74.7 % versus 91.8 %, p < 0.0001). There were 13 MACE (8.2 %) in patients with high SYNTAX scores and two MACE (1.4 %) in those with low scores. The SYNTAX and J-CTO scores had odds ratios of 3.33 (95 %CI, 1.44-7.74) and 3.64 (95 %CI, 1.24-10.66) for procedural failure. A higher SYNTAX score (> 22) was also an independent predictor of 30-day MACE after PCI (odds ratio = 4.80, 95 %Cl 1.03-22.42). CONCLUSION: The SYNTAX score is predictive of procedural failure, as is the J-CTO score. Furthermore, a higher SYNTAX score is strongly associated with an increased risk of 30-day MACE. The SYNTAX score is useful for clinical decision making when treating patients with complex CTO lesions.

Asunto(s)

Angiografía Coronaria/métodos , Oclusión Coronaria/mortalidad , Oclusión Coronaria/cirugía , Evaluación de Resultado en la Atención de Salud/métodos , Intervención Coronaria Percutánea/mortalidad , Complicaciones Posoperatorias/mortalidad , Anciano , Angiografía Coronaria/estadística & datos numéricos , Oclusión Coronaria/diagnóstico por imagen , Femenino , Humanos , Japón/epidemiología , Masculino , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Análisis de Supervivencia , Resultado del Tratamiento

Asunto(s)

Glucemia , Infarto del Miocardio/sangre , Anciano , Electrocardiografía , Femenino , Humanos , Masculino , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/cirugía , Intervención Coronaria Percutánea , Estudios Prospectivos

Asunto(s)

Cateterismo Cardíaco/métodos , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/cirugía , Anciano , Humanos , Japón , Masculino , Radiografía

RESUMEN

Introducción y objetivos En estudios previos se ha descrito que la intervención coronaria aplicada a lesiones complejas presenta una correlación independiente con las hemorragias mayores. La puntuación SYNTAX es un instrumento angiográfico utilizado para evaluar el grado de complejidad de las enfermedades arteriales coronarias. El objetivo de este estudio es evaluar la capacidad de la puntuación SYNTAX para predecir hemorragias mayores tras el implante de stents liberadores de fármacos. Métodos Se analizó a un total de 722 pacientes sometidos a implante de stents liberadores de fármacos de una población de pacientes consecutivos incluidos en el estudio entre enero de 2007 y abril de 2010. Se investigó la incidencia de hemorragias mayores y trombosis delstent durante un periodo de 2 años. La hemorragia mayor se evaluó mediante la puntuación CRUSADE y los criterios del Bleeding Academic Research Consortium. Se estratificó a los pacientes en los siguientes grupos según los criterios del ensayo SYNTAX: baja (≤ 22; n = 484), intermedia (23-32; n = 128) y alta (≥ 33; n=110). Resultados: Se observaron hemorragias mayores en 47 pacientes (6,5%) en el periodo de estudio de 2 años, y hubo 12 episodios de trombosis del stent (1,7%). Las tasas de hemorragia mayor en los pacientes de los terciles bajo, intermedio y alto de la puntuación SYNTAX fueron del 2,9, el 7,8 y el 20,9% respectivamente (p<0,0001). La puntuación SYNTAX mostró una hazard ratio ajustada de hemorragia mayor a los 2 años de 1,81 (intervalo de confianza del 95%, 1,27-2,57). El valor predictivo del área bajo la curva de características operativas del receptor ajustada por hemorragia mayor mejoró significativamente tras la inclusión de la puntuación CRUSADE (estadístico C, 0,890 frente a 0,812). Conclusiones: Aunque la puntuación SYNTAX puede predecir el riesgo de hemorragias mayores, el valor predictivo de la puntuación CRUSADE fue superior. Estas puntuaciones pueden resultar de utilidad en la toma de decisiones clínicas respecto a las estrategias de revascularización y la duración óptima del tratamiento antiagregante plaquetario doble tras implante de stents liberadores de fármacos

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Introduction and objectives Previous studies have eported that coronary intervention for complex lesions is independently correlated with major bleeding. The SYNTAX score is an angiographic tool used to grade the complexity of coronary artery diseases. The aim of this study was to assess the ability of the SYNTAX score to predict major bleeding following drug-eluting stent implantation. Methods We analyzed 722 patients who underwent drug-eluting stent implantation in an all-comers population between January 2007 and April 2010. The incidence of major bleeding and stent thrombosis was investigated during a 2-year period. Major bleeding was evaluated using the CRUSADE score and Bleeding Academic Research Consortium criteria. Patients were stratified into the following groups according to the SYNTAX trial: low (≤ 22; n = 484), intermediate (23–32; n = 128), and high (≥ 33; n = 110).Results Major bleeding was observed in 47 patients (6.5%) during the 2-year period, and there were 12 incidents of stent thrombosis (1.7%). Major bleeding rates for patients in the low, intermediate, and high SYNTAX score tertiles were 2.9%, 7.8%, and 20.9%, respectively (P < .0001). The SYNTAX score had an adjusted hazard ratio of 1.81 (95% confidence interval, 1.27-2.57) for 2-year major bleeding. The predictive value of the adjusted area under the receiver operating characteristic curve for major bleeding significantly improved after inclusion of the CRUSADE score (C statistic, 0.890 vs 0.812). Conclusions: Although the SYNTAX score can predict major bleeding risk, the predictive value of the CRUSADE score was higher. These scores may be useful in clinical decision-making on revascularization strategies and on the optimal duration of dual antiplatelet therapy following drug-eluting stent implantation

Asunto(s)

Humanos , Inhibidores de Agregación Plaquetaria/uso terapéutico , Hemorragia Posoperatoria/prevención & control , Angioplastia Coronaria con Balón/métodos , Stents Liberadores de Fármacos , Infarto del Miocardio/cirugía , Pérdida de Sangre Quirúrgica/prevención & control , Ajuste de Riesgo/métodos , Factores de Riesgo , Revascularización Miocárdica

RESUMEN

INTRODUCTION AND OBJECTIVES: Previous studies have reported that coronary intervention for complex lesions is independently correlated with major bleeding. The SYNTAX score is an angiographic tool used to grade the complexity of coronary artery diseases. The aim of this study was to assess the ability of the SYNTAX score to predict major bleeding following drug-eluting stent implantation. METHODS: We analyzed 722 patients who underwent drug-eluting stent implantation in an all-comers population between January 2007 and April 2010. The incidence of major bleeding and stent thrombosis was investigated during a 2-year period. Major bleeding was evaluated using the CRUSADE score and Bleeding Academic Research Consortium criteria. Patients were stratified into the following groups according to the SYNTAX trial: low (≤ 22; n=484), intermediate (23-32; n=128), and high (≥ 33; n=110). RESULTS: Major bleeding was observed in 47 patients (6.5%) during the 2-year period, and there were 12 incidents of stent thrombosis (1.7%). Major bleeding rates for patients in the low, intermediate, and high SYNTAX score tertiles were 2.9%, 7.8%, and 20.9%, respectively (P < .0001). The SYNTAX score had an adjusted hazard ratio of 1.81 (95% confidence interval, 1.27-2.57) for 2-year major bleeding. The predictive value of the adjusted area under the receiver operating characteristic curve for major bleeding significantly improved after inclusion of the CRUSADE score (C statistic, 0.890 vs 0.812). CONCLUSIONS: Although the SYNTAX score can predict major bleeding risk, the predictive value of the CRUSADE score was higher. These scores may be useful in clinical decision-making on revascularization strategies and on the optimal duration of dual antiplatelet therapy following drug-eluting stent implantation.

Asunto(s)

Angiografía Coronaria , Enfermedad de la Arteria Coronaria/cirugía , Stents Liberadores de Fármacos/efectos adversos , Hemorragia Posoperatoria/diagnóstico por imagen , Medición de Riesgo/métodos , Anciano , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Estimación de Kaplan-Meier , Masculino , Hemorragia Posoperatoria/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia/tendencias , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

PURPOSE: To determine the predictive value of skin perfusion pressure (SPP) for wound healing after endovascular therapy (EVT). METHODS: Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age 71.5±12.5 years) with CLI (123 limbs) underwent successful balloon angioplasty ± stenting (flow from >1 vessel to the foot without bypass) and were physically able to undergo SPP measurement before and within 48 hours after EVT. The status of wound healing was recorded over a mean follow-up of 17.4±12.4 months. RESULTS: The wound healing rate was 78.9% (97 limbs of 89 patients). SPP values after EVT were significantly higher in these patients than in the 24 patients (26 limbs) without wound healing (44.2±15.6 mmHg vs. 27.5±10.4 mmHg, p<0.001). Receiver operating characteristics analysis of SPP after EVT to predict wound healing had an area under the curve of 0.81 (95% CI 0.723 to 0.899, p<0.001). The optimal cutoff for predicting wound healing was 30 mmHg, with a sensitivity of 81.4% and a specificity of 69.2%. Binary logistic regression analysis demonstrated SPP after EVT to be an independent predictor of wound healing (p<0.001). The probability of wound healing with SPP values >30 mmHg, 40 mmHg, and 50 mmHg were 69.8%, 86.3%, and 94.5%, respectively. CONCLUSION: SPP after EVT is an independent predictor of wound healing in patients with CLI. In our study, an SPP value of 30 mmHg was shown to be the best cutoff for prediction of wound healing after EVT.

Asunto(s)

Angioplastia de Balón , Isquemia/terapia , Extremidad Inferior/irrigación sanguínea , Microcirculación , Piel/irrigación sanguínea , Cicatrización de Heridas , Anciano , Anciano de 80 o más Años , Angioplastia de Balón/efectos adversos , Angioplastia de Balón/instrumentación , Área Bajo la Curva , Enfermedad Crítica , Humanos , Isquemia/diagnóstico , Isquemia/fisiopatología , Japón , Modelos Logísticos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Flujo Sanguíneo Regional , Estudios Retrospectivos , Stents , Factores de Tiempo , Resultado del Tratamiento

Asunto(s)

Oclusión Coronaria/diagnóstico por imagen , Oclusión Coronaria/cirugía , Intervención Coronaria Percutánea/métodos , Índice de Severidad de la Enfermedad , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Angiografía Coronaria/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

The purpose of this study was to evaluate whether the carotid intima-media thickness (cIMT) and intima-media thickness variability (IMTV) along the artery are correlated to the ankle-brachial index (ABI) in Japanese coronary artery disease patients. Five hundred consecutive patients (312 males; median age 69 ± 11 years) who underwent carotid ultrasonography and first coronary angiography were prospectively analyzed. By using automated software (AtheroEdge™, AtheroPoint, Roseville, CA, USA), we obtained the cIMT and IMTV. Pearson correlation analysis was performed to calculate the association between ABI, automatically measured cIMT, automatically measured IMTV, and the SYNTAX score. The mean cIMT was 0.881 ± 0.334 mm and the mean IMTV was 0.141 ± 0.112. IMTV was negatively and significantly correlated to ABI (ρ = -0.147; p = 0.001), whereas cIMT was not (ρ = -0.075; p = 0.097). IMTV and cIMT had the same significant correlation with the SYNTAX score. When we considered patients with a higher risk factor (ABI ≤ 0.9), we found higher values of IMTV and the SYNTAX score, but not higher values of cIMT. Logistic regression analysis showed that IMTV was independently associated with the complexity of the coronary artery disease (as assessed by the SYNTAX score). In conclusion, we show that IMTV automatically measured using AtheroEdge™ was correlated with ABI, whereas cIMT was not. IMTV could be integrated with cIMT measurement to improve the assessment of cardiovascular disease.

Asunto(s)

Índice Tobillo Braquial , Arterias Carótidas/diagnóstico por imagen , Grosor Intima-Media Carotídeo/estadística & datos numéricos , Enfermedad de la Arteria Coronaria , Anciano , Índice Tobillo Braquial/métodos , Índice Tobillo Braquial/estadística & datos numéricos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/epidemiología , Femenino , Humanos , Japón/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Valor Predictivo de las Pruebas , Factores de Riesgo , Índice de Severidad de la Enfermedad , Estadística como Asunto , Túnica Íntima/diagnóstico por imagen , Túnica Media/diagnóstico por imagen

RESUMEN

In the era of drug-eluting stents (DES), a long-term dual antiplatelet therapy is required to prevent late stent thrombosis. However, in patients with atrial fibrillation (AF), there is a concern that combining warfarin with dual antiplatelet therapy may increase the risk of bleeding. We analyzed 1274 consecutive patients with coronary artery disease who were treated with coronary intervention from January 2006 through January 2009. Of these, we enrolled 74 AF patients treated with DES and dual antiplatelet therapy as well as warfarin. The primary endpoint was the incidence of major bleeding within 3 years; the predictive factor of major bleeding was also analyzed. To evaluate the efficacy of anticoagulant therapy, time in therapeutic range (TTR) was also measured. The 3-year incidence of major bleeding was 12.2 % (nine of 74 patients). The average observation period was 25.7 ± 20.2 months. Mean TTR value was 44.6 ± 33.0 % and was maintained at a relatively low level. Multivariate analysis revealed that a higher CHADS2 score (2-point more) was an independent predictor of increased risk of major bleeding. Major bleeding in the patients with triple antithrombotic therapy including warfarin occurred at a relatively high rate. Although the higher CHADS2-score indicates a high risk of thrombotic events, it was strongly associated with bleeding complications.

Asunto(s)

Anticoagulantes/efectos adversos , Fibrilación Atrial/tratamiento farmacológico , Stents Liberadores de Fármacos , Hemorragia/inducido químicamente , Inhibidores de Agregación Plaquetaria/efectos adversos , Warfarina/efectos adversos , Anciano , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Aspirina/administración & dosificación , Aspirina/efectos adversos , Aspirina/uso terapéutico , Fibrilación Atrial/complicaciones , Clopidogrel , Enfermedad de la Arteria Coronaria/terapia , Quimioterapia Combinada , Stents Liberadores de Fármacos/efectos adversos , Femenino , Humanos , Masculino , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/uso terapéutico , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/prevención & control , Tienopiridinas/administración & dosificación , Tienopiridinas/efectos adversos , Tienopiridinas/uso terapéutico , Ticlopidina/administración & dosificación , Ticlopidina/efectos adversos , Ticlopidina/análogos & derivados , Ticlopidina/uso terapéutico , Warfarina/administración & dosificación , Warfarina/uso terapéutico

RESUMEN

AIMS: The purpose of this study was to evaluate whether carotid IMT (cIMT) identified using automated software is associated with HbA1c in Japanese patients with coronary artery disease. METHODS: 370 consecutive patients (males 218; median age 69 years ± 11) who underwent carotid-US and first coronary angiography were prospectively analyzed. After ultrasonographic examinations were performed, the plaque score (PS) was calculated and automated IMT analysis was obtained with a dedicated algorithm. Pearson correlation analysis was performed to calculate the association between automated IMT, PS and HbA1c. RESULTS: The mean value of cIMT was 1.00 ± 0.47 mm for the right carotid and 1.04 ± 0.49 mm for the left carotid; the average bilateral value was 1.02 ± 0.43 mm. No significant difference of cIMT was detected between men and women. We found a direct correlation between cIMT values and HbA1c (p=0.0007) whereas the plaque score did not correlate with the HbA1c values (p>0.05) CONCLUSION: The results of our study confirm that automated cIMT values and levels of HbA1c in Japanese patients with coronary artery disease are correlated whereas the plaque score does not show a statistically significant correlation.

Asunto(s)

Enfermedad de la Arteria Coronaria/metabolismo , Enfermedad de la Arteria Coronaria/patología , Hemoglobina Glucada/metabolismo , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Grosor Intima-Media Carotídeo , Femenino , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

BACKGROUND: Although clinical restenosis within 1 year after percutaneous coronary intervention has been remarkably reduced with the advent of drug-eluting stents (DES), the late catch-up (LCU) phenomenon remains an issue despite medical advances. The aim of this study was to investigate the incidence and predictive factors of the LCU phenomenon in an unselected population treated with first-generation DES. METHODS: A total of 923 patients treated with DES between June 2004 and August 2008 were analyzed. The LCU phenomenon was defined as secondary revascularization 1 year after index stenting. Retreatment for very late stent thrombosis was considered as part of the LCU phenomenon. RESULTS: Incidence of the LCU phenomenon was seen in 33 patients (3.6%). Very late stent thrombosis was observed in 5 patients (0.6%) and very late in-stent restenosis was observed in 28 patients (3.0%). At the 12-month landmark analysis, the cumulative rate of cardiac death was significantly higher in patients with the LCU phenomenon than in those without any target lesion revascularization (9.0% vs. 0.9%, p<0.001). In the multivariate analysis, hemodialysis [odds ratio (OR) 6.07, p=0.003], number of stents (OR 1.58, p=0.02), and coronary bifurcation lesions (OR 2.06, p=0.048) were identified as independent predictors of the LCU phenomenon. CONCLUSION: The LCU phenomenon is associated with serious consequences and adverse events and remains an important issue in modern practice, despite medical advances. DES should be deployed with a minimum number of stents, and special consideration must be given to patients on hemodialysis and those with coronary bifurcation lesions.

Asunto(s)

Reestenosis Coronaria/epidemiología , Stents Liberadores de Fármacos/efectos adversos , Trombosis/epidemiología , Trombosis/etiología , Anciano , Femenino , Humanos , Incidencia , Masculino , Pronóstico , Estudios Prospectivos , Retratamiento , Factores de Tiempo