RESUMEN
OBJECTIVE: The recent PLATINUM trial has demonstrated that the use of the new generation platinum chromium everolimus-eluting stents (PtCr-EES) yield clinical outcomes similar to those obtained by the use of cobalt chromium everolimus-eluting stents (CoCr-EES) in selected patients with 1 or 2 de novo coronary artery lesions. This study aimed to compare the safety and efficacy of the PtCr-EES and CoCr-EES in unselected patients from a real-life single-center registry. PATIENTS AND METHODS: From July 2009 through November 2010, 788 consecutive patients in our institution with symptomatic coronary artery disease who were treated with the CoCr-EES (n = 410) or PtCr-EES (n = 378) were enrolled into this study. The primary endpoint of the study was target-lesion failure (TLF) at 12-month follow-up and the secondary endpoints were major adverse cardiovascular events and stent thrombosis. RESULTS: The prevalence of TLF in the PtCr-EES group (4.5%) was similar to that in the CoCr-EES group (3.9%). In addition, there were no significant differences in the 12-month rates of cardiac death (2.1% vs. 1.5%), myocardial infarction (2.4% vs. 3.9%), ischemia-driven target lesion revascularization (2.4% vs. 2.2%), and definite or probable stent thrombosis (0.5% vs. 1.5%, all p > 0.05). CONCLUSIONS: At 12-month follow-up, the PtCr-EES is comparable in safety and efficacy to the CoCr-EES in unselected patients with coronary artery diseases.
Asunto(s)
Cromo/normas , Cobalto/normas , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Stents Liberadores de Fármacos/normas , Everolimus/administración & dosificación , Intervención Coronaria Percutánea/normas , Platino (Metal)/normas , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/instrumentación , Radiografía , Resultado del TratamientoRESUMEN
INTRODUCTION: Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) can be performed using different types of ablation catheter. Gold tip electrodes have the theoretical advantage of creating bigger lesions than standard platinum-iridium electrode. This prospective, randomized study compares the clinical efficacy of 8-mm gold tip catheter, externally irrigated and 8-mm platinum-iridium tip (Pt tip) catheters. METHODS AND RESULTS: Sixty consecutive patients (51 men, 60 +/- 10 years) undergoing de novo CTI ablation for documented typical atrial flutter were randomized to one of the following ablation catheters: 8-mm gold tip catheter, an externally irrigated-tip (Irr. tip) catheter, or an 8-mm Pt tip catheter. The procedural endpoint was achievement of bidirectional isthmus conduction block with < or = 20 minutes of RF energy application. The latter was achieved equally with the 3 catheters (95% for gold tip, 100% for irrigated tip, 95% for Pt tip) and the durations of RF (10 +/- 6, 10 +/- 4, 13 +/- 8 minutes), fluoroscopy (12 +/- 6, 12 +/- 7, 15 +/- 12 minutes) and the procedure (34 +/- 23, 38 +/- 24, 40 +/- 30 minutes) were similar in all groups. The maximal targeted power could not be reached in at least one location in 40% of patients with gold tip and in 35% of patients with Pt tip catheters whereas it was always achieved with an Irr. tip catheter (P = 0.003, P = 0.008). The reduction in impedance during RF delivery was greater with Irr. tip (11 +/- 7 ohms) than with gold (7 +/- 4 ohms, P = 0.02) or Pt tip (5 +/- 3 ohms, P = 0.001) catheters. CONCLUSION: This study demonstrates equivalent efficacies of gold, platinum-iridium and externally Irr. tip catheters for successful de novo ablation of the CTI.
Asunto(s)
Ablación por Catéter/instrumentación , Oro , Iridio , Platino (Metal) , Válvula Tricúspide/cirugía , Anciano , Aleteo Atrial/patología , Aleteo Atrial/cirugía , Ablación por Catéter/métodos , Cateterismo/normas , Femenino , Estudios de Seguimiento , Oro/normas , Humanos , Iridio/normas , Masculino , Persona de Mediana Edad , Platino (Metal)/normas , Estudios Prospectivos , Válvula Tricúspide/patologíaRESUMEN
The rat electrical kindling model has been widely utilized in epilepsy research. This study aimed to identify the optimum "MRI compatible" bipolar stimulating and recording electrodes to enable serial MRI acquisition in this model. Two types of custom-made electrodes (gold and carbon) were compared with commercial platinum-iridium alloy electrodes for suitability based on size, effect on image quality and kindling induction. The custom-made gold electrodes, based on these parameters, were found to be most suitable. These electrodes enable the study of epileptogenesis utilizing MRI in this model of temporal lobe epilepsy (TLE).