methods (balloons with jets, leaks or even needles, coated stents, etc.) are too rough for the tiny endothelial and subendothelial tissues. Despite reports about the feasibility and safety of different local drug delivery devices, their clinical effectiveness has yet to be proved. Increased risk of arterial thrombosis after local delivery of some drugs is one major issue, but probably the most ...

BACKGROUND/OBJECTIVES A large number of patients with coronary artery disease experience angina that is not suitable for revascularization and is refractory to conventional medical therapy. Laboratory and preclinical studies have provided evidence for the safety and potential efficacy of autologous CD34+ stem cell therapies as treatment for angina. Clinical studies investigating intramyocardial...

S tent thrombosis is the sudden occlusion of a stented coronary artery due to thrombus formation. Despite major improvements in antiplatelet therapy, thrombotic events remain the primary cause of death after percutaneous coronary interventions. The clinical consequences of stent thrombosis are frequently catastrophic and include death in 20% to 48% of cases or major myocardial infarction in 60%...

Intravenous adenosine is considered the drug of choice to obtain maximum hyperemia in the measurement of the fractional flow reserve (FFR). However, comparative studies performed between intravenous and intracoronary administration have not used high doses of intracoronary adenosine. The present study compared the efficacy and safety of high doses of intracoronary adenosine to intravenous admin...

To assess the effect of autologous bone-marrow cell (BMC) therapy in patients with acute myocardial infarction in a rigorous double-blind, randomized, placebo-controlled trial. Patients with reperfusion >6 hours after symptom onset were randomly assigned in a 2:1 ratio to receive intracoronary BMC or placebo therapy 5 to 7 days after symptom onset. The patients were stratified according to age,...

Klotsche J, TonnT, Dimmeler S, Zeiher AM. Effect of shock wave-facilitated intracoronary cell therapy on LVEF in patients with chronic heart failure: the CELLWAVE randomized clinical trial. JAMA 2013;309:1622–1631. 12. Malliaras K, Makkar RR, Smith RR, Cheng K, Wu E, Bonow RO, Marbán L, Mendizabal A, Cingolani E, Johnston PV, Gerstenblith G, Schuleri KH, Lardo AC, Marbán E. Intracoronary cardio...

The Meta-Analysis of Cell-Based Cardiac Studies (ACCRUE) consortium recently published the results of the first prospective individual patient data (IPD)–based meta-analysis that included 12 randomized clinical trials investigating 1-year outcomes in patients with recent STsegment–elevation myocardial infarction (STEMI), who received intracoronary autologous stem and progenitor cells. This IPD ...

The positive effect of vitamin C on left ventricular (LV) inotropic responses to dobutamine, observed in patients with preserved LV function, is lost in heart failure (HF). We tested the hypothesis that in HF, endogenous nitric oxide (NO) opposes the positive effect of vitamin C on adrenergically stimulated contractility by examining the effects of vitamin C on dobutamine responses during NO sy...

Intracoronary stents have markedly improved the outcomes of catheter-based coronary interventions. Intracoronary stent implantation rates of over 90% during coronary angioplasty are common. Stent implantations are associated with a small but statistically significant number of adverse outcomes including restenosis, thrombosis, strut malapposition, incomplete strut endothelialization, and variou...

AIMS To assess the value of videodensitometric quantification of the coronary lumen after angioplasty by comparison to two other techniques of coronary artery lumen quantification. METHODS AND RESULTS Videodensitometric quantitative angiography, edge detection quantitative angiography and 30 MHz intracoronary ultrasound imaging were performed after successful balloon angioplasty in 161 patien...