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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Related Experiment Video

Updated: Sep 16, 2025

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Stent Failure Management in Contemporary Clinical Practice.

Iosif Xenogiannis1, Charalampos Varlamos1, Despoina-Rafailia Benetou1

  • 1Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Chaidari, 12461 Athens, Greece.

Diagnostics (Basel, Switzerland)
|July 12, 2025
PubMed
Summary

Approximately 9% of patients undergoing percutaneous coronary intervention (PCI) experience stent failure (SF), manifesting as in-stent restenosis or stent thrombosis. Drug-coated balloons are a common alternative to new stent implantation for SF cases, particularly in-stent restenosis.

Keywords:
drug-coated balloonsdrug-eluting stentsin-stent restenosisintravascular imagingstent failurestent thrombosis

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Contemporary stent technology has advanced, yet stent failure (SF), including in-stent restenosis (ISR) and stent thrombosis (ST), remains a clinical challenge.
  • SF affects a notable percentage of patients post-percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To compare clinical characteristics, presentation, angiographic findings, and management of patients with SF versus de novo lesions undergoing PCI.
  • To identify the underlying mechanisms and procedural strategies for SF management.

Main Methods:

  • Observational, single-center study comparing 101 SF cases with patients undergoing PCI for de novo lesions.
  • Analysis of baseline characteristics, clinical presentation, procedural interventions, and intravascular imaging findings.

Main Results:

  • SF occurred in 9% of 1120 PCI patients; 75% had ISR, 25% had ST.
  • SF patients had higher rates of diabetes, dyslipidemia, and prior bypass surgery, and lower rates of current smoking.
  • Drug-coated balloons (44%) and plain balloon angioplasty (8.9%) were used more frequently in SF cases compared to de novo lesions (5.3% and 0.7%, respectively).
  • Intracoronary imaging use was higher in the SF group (33% vs. 13%).
  • Stent malapposition and neoatherosclerosis were key mechanisms for ST and ISR, respectively.
  • Procedural success rates were comparable (96% vs. 98%).

Conclusions:

  • About 1 in 10 PCI patients experience stent failure.
  • Intracoronary imaging plays a crucial role in managing SF.
  • While drug-eluting stent implantation is standard for de novo lesions, drug-coated balloons are a preferred alternative for ISR.
  • Interventional cardiologists must master intravascular imaging interpretation for optimal SF treatment outcomes.