Restenosis after Intervention with New Mechanical Devices -

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Résumé :
From the Foreword by Eric J. Topol In the past five years, interventional cardiology has entered a new era of evaluating percutaneous transcatheter technologies to treat coronary artery disease and prevent restenosis. Cardiologists attempting to follow this new and exciting field may easily be confused by the growth and expansion of new devices, the technical details relevant to each device and enthusiastic claims of success. This monograph is a comprehensive and objective assessment of restenosis from the perspective of these new technologies including stenting, atherectomy, rotational abrasion and lasers, written by innovators and pioneers. The international breadth of experience is reflected in the summary of experiences from both sides of the Atlantic, at times with conflicting observations and results which in itself is valuable, given the diverse experience to date. In addition to the lucid summaries of the early and late results of these new devices, important issues in the methodology of restenosis research are addressed, including limitations of quantitative coronary arteriography in evaluating the new devices and important advances in alternatives to arteriography such as intravascular imaging. As a whole, this monograph is exceptionally worthwhile owing to its complete, up-to-date, balanced and visionary elements. There is no question that the new coronary device era has ushered in some excitement, and some despair. This book serves a pivotal purpose by weaving so many new concepts together, establishing the groundwork for further development of mechanical approaches to limit restenosis. I heartily recommend this text to all interventional cardiologists interested in practical and research aspects of restenosis.

Sommaire:
One: Assessment of Stenosis/Restenosis - Present and Future.- 1. Methodologic aspects of quantitative coronary angiography (QCA) in interventional cardiology.- Two: Intravascular Imaging.- - Historical aspects of intravascular imaging.- 2. Potential of intravascular ultrasound imaging in the evaluation of morphology, elastic properties and vasomotor function of coronary arteries.- 3. Intravascular ultrasound imaging following mechanical coronary interventions: theoretic advantages and initial clinical experience.- 4. Ultrasound guidance for catheter-based plaque removal and ablation techniques: potentional impact on restenosis.- 5. Intravascular ultrasound: potential for optimizing mechanical solutions to restenosis.- 6. Evaluation of restenosis following new coronary interventions.- Three: Stents Restenosis and New Techniques.- Introduction: Stenting for restenosis?.- 7. The Wallstent experience: 1986-1990.- 8. Restenosis after Palmaz-Schatz stent implantation.- 9. Restenosis after Gianturco-Roubin stent. Placement for acute closure.- 10. Immediate and long-term morphologic changes in stenosis geometry after WiktorTM stent implantation in native coronary arteries for recurrent stenosis following balloon angioplasty. Report on the first fifty consecutive patients.- Four: Atherectomy.- 11. Restenosis: directional coronary atherectomy.- 12. Transluminal extraction endarterectomy.- Five: Rotational Ablation.- Introduction: Angioplasty with high speed rotary ablation.- 13. Percutaneous transluminal coronary rotary ablation with Rotablator: European experience.- 14. Percutaneous coronary rotational atherectomy: the William Beaumont Hospital experience.- 15. Percutaneous transluminal coronary rotational ablation: serial follow-up by quantitative angiography.- Six:Lasers.- 16. Improved luminal dimensions and local pharmacological therapy with laser balloon angioplasty for potential mitigation of angioplasty restenosis.- 17. Laser balloon angioplasty: European experience.- 18. Coronary laser angioplasty.- 19. Restenosis following laser angioplasty.- 20. Sapphire-probe laser angioplasty - European experience.- 21. Excimer laser assisted angioplasty of peripheral vessels.- 22. Clinical results of percutaneous coronary excimer laser angioplasty trials.- 23. Direct laser ablation of coronary arterosclerotic plaque in humans - the German experience.- 24. Summary.