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| ===[[PCI Equipment: Balloon Selection|Balloon Selection]]=== | | ===[[PCI Equipment: Balloon Selection|Balloon Selection]]=== |
| ===[[PCI Equipment: Stent Selection|Stent Selection]]=== | | ===[[PCI Equipment: Stent Selection|Stent Selection]]=== |
| *[[Drug eluting stent]] ([[Drug eluting stent|DES]]) and [[bare metal stent]] ([[Bare metal stent|BMS]] are two main types of [[stents]] that are used during [[percutaneous coronary intervention]] ([[PCI]]).<ref name="pmid34895950">{{cite journal| author=Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM | display-authors=etal| title=2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=J Am Coll Cardiol | year= 2022 | volume= 79 | issue= 2 | pages= e21-e129 | pmid=34895950 | doi=10.1016/j.jacc.2021.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34895950 }} </ref>
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| *Compared to the fist generation of [[DES]], newer [[DES]] are optimized in [[drug]], polymer, and [[stent]] design. This significant evolution in [[DES]] technology leads to lower rate of [[stent]] [[thrombosis]] and [[mortality rate]].<ref name="pmid17145250">{{cite journal| author=Bavry AA, Kumbhani DJ, Helton TJ, Borek PP, Mood GR, Bhatt DL| title=Late thrombosis of drug-eluting stents: a meta-analysis of randomized clinical trials. | journal=Am J Med | year= 2006 | volume= 119 | issue= 12 | pages= 1056-61 | pmid=17145250 | doi=10.1016/j.amjmed.2006.01.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17145250 }} </ref><ref name="pmid17296822">{{cite journal| author=Lagerqvist B, James SK, Stenestrand U, Lindbäck J, Nilsson T, Wallentin L | display-authors=etal| title=Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 10 | pages= 1009-19 | pmid=17296822 | doi=10.1056/NEJMoa067722 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17296822 }} </ref><ref name="pmid15963413">{{cite journal| author=Ong AT, McFadden EP, Regar E, de Jaegere PP, van Domburg RT, Serruys PW| title=Late angiographic stent thrombosis (LAST) events with drug-eluting stents. | journal=J Am Coll Cardiol | year= 2005 | volume= 45 | issue= 12 | pages= 2088-92 | pmid=15963413 | doi=10.1016/j.jacc.2005.02.086 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15963413 }} </ref><ref name="pmid17020889">{{cite journal| author=Nordmann AJ, Briel M, Bucher HC| title=Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 23 | pages= 2784-814 | pmid=17020889 | doi=10.1093/eurheartj/ehl282 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17020889 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=17474675 Review in: ACP J Club. 2007 May-Jun;146(3):66] </ref>
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| *Currently available [[DES]] is superior to both first-generation [[DES]] and [[BMS]] due to higher efficacy and safety and lower [[restenosis]] rates.<ref name="pmid31056295">{{cite journal| author=Piccolo R, Bonaa KH, Efthimiou O, Varenne O, Baldo A, Urban P | display-authors=etal| title=Drug-eluting or bare-metal stents for percutaneous coronary intervention: a systematic review and individual patient data meta-analysis of randomised clinical trials. | journal=Lancet | year= 2019 | volume= 393 | issue= 10190 | pages= 2503-2510 | pmid=31056295 | doi=10.1016/S0140-6736(19)30474-X | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31056295 }} </ref><ref name="pmid26065988">{{cite journal| author=Palmerini T, Benedetto U, Biondi-Zoccai G, Della Riva D, Bacchi-Reggiani L, Smits PC | display-authors=etal| title=Long-Term Safety of Drug-Eluting and Bare-Metal Stents: Evidence From a Comprehensive Network Meta-Analysis. | journal=J Am Coll Cardiol | year= 2015 | volume= 65 | issue= 23 | pages= 2496-507 | pmid=26065988 | doi=10.1016/j.jacc.2015.04.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26065988 }} </ref><ref name="pmid24459196">{{cite journal| author=Kang SH, Park KW, Kang DY, Lim WH, Park KT, Han JK | display-authors=etal| title=Biodegradable-polymer drug-eluting stents vs. bare metal stents vs. durable-polymer drug-eluting stents: a systematic review and Bayesian approach network meta-analysis. | journal=Eur Heart J | year= 2014 | volume= 35 | issue= 17 | pages= 1147-58 | pmid=24459196 | doi=10.1093/eurheartj/eht570 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24459196 }} </ref><ref name="pmid24212107">{{cite journal| author=Bangalore S, Toklu B, Amoroso N, Fusaro M, Kumar S, Hannan EL | display-authors=etal| title=Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. | journal=BMJ | year= 2013 | volume= 347 | issue= | pages= f6625 | pmid=24212107 | doi=10.1136/bmj.f6625 | pmc=3898413 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24212107 }} </ref>
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| *The following [[stents]] are listed from more safe to less safe based on several [[meta-analyses]]:<ref name="pmid31056295">{{cite journal| author=Piccolo R, Bonaa KH, Efthimiou O, Varenne O, Baldo A, Urban P | display-authors=etal| title=Drug-eluting or bare-metal stents for percutaneous coronary intervention: a systematic review and individual patient data meta-analysis of randomised clinical trials. | journal=Lancet | year= 2019 | volume= 393 | issue= 10190 | pages= 2503-2510 | pmid=31056295 | doi=10.1016/S0140-6736(19)30474-X | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31056295 }} </ref><ref name="pmid26065988">{{cite journal| author=Palmerini T, Benedetto U, Biondi-Zoccai G, Della Riva D, Bacchi-Reggiani L, Smits PC | display-authors=etal| title=Long-Term Safety of Drug-Eluting and Bare-Metal Stents: Evidence From a Comprehensive Network Meta-Analysis. | journal=J Am Coll Cardiol | year= 2015 | volume= 65 | issue= 23 | pages= 2496-507 | pmid=26065988 | doi=10.1016/j.jacc.2015.04.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26065988 }} </ref><ref name="pmid24459196">{{cite journal| author=Kang SH, Park KW, Kang DY, Lim WH, Park KT, Han JK | display-authors=etal| title=Biodegradable-polymer drug-eluting stents vs. bare metal stents vs. durable-polymer drug-eluting stents: a systematic review and Bayesian approach network meta-analysis. | journal=Eur Heart J | year= 2014 | volume= 35 | issue= 17 | pages= 1147-58 | pmid=24459196 | doi=10.1093/eurheartj/eht570 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24459196 }} </ref><ref name="pmid24212107">{{cite journal| author=Bangalore S, Toklu B, Amoroso N, Fusaro M, Kumar S, Hannan EL | display-authors=etal| title=Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. | journal=BMJ | year= 2013 | volume= 347 | issue= | pages= f6625 | pmid=24212107 | doi=10.1136/bmj.f6625 | pmc=3898413 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24212107 }} </ref>
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| **Durable-polymer [[DES]]
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| **[[Biodegradable]]-polymer [[DES]]
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| **[[BMS]]
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| ====ACA 2021 Revascularization Guideline====
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| {|class="wikitable"
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| | colspan="1" style="text-align:center; background:lightgreen"|Class 1 Recommendation, Level of Evidence: A<ref name="pmid34895950">{{cite journal| author=Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM | display-authors=etal| title=2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=J Am Coll Cardiol | year= 2022 | volume= 79 | issue= 2 | pages= e21-e129 | pmid=34895950 | doi=10.1016/j.jacc.2021.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34895950 }} </ref>
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| | bgcolor="lightgreen"| [[DES]] is preferred over [[BMS]] in [[patients]] undergoing [[PCI]] to [[Prevention (medical)|prevent]] [[restenosis]], [[ST elevation myocardial infarction|MI]], or [[Stent thrombosis definition|acute stent thrombosis]].
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| |}
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| ==References== | | ==References== |