Despite the obvious benefits of using ureteral stents to drain the ureters, there is also a risk of complications from 80-90%. The presence of a foreign body in the human body causes disturbances in its proper functioning. It can lead to biofilm formation on the stent surface, which may favor the development of urinary tract infections or the formation of encrustation, as well as stent fragmentation, complicating its subsequent removal. In this work, the effect of the polymeric coating containing the active substance-papaverine hydrochloride on the functional properties of ureteral stents significant for clinical practice were assessed. Methods: The most commonly clinically used polyurethane ureteral Double-J stent was selected for the study. Using the dip-coating method, the surface of the stent was coated with a poly(D,L-lactide-glycolide) (PLGA) coating containing the papaverine hydrochloride (PAP). In particular, strength properties, retention strength of the stent ends, dynamic frictional force, and the fluoroscopic visibility of the stent during X-ray imaging were determined. Results: The analysis of the test results indicates the usefulness of a biodegradable polymer coating containing the active substance for the modification of the surface of polyurethane ureteral stents. The stents coated with PLGA+PAP coating compared to polyurethane stents are characterized by more favorable strength properties, the smaller value of the dynamic frictional force, without reducing the fluoroscopic visibility.

• Klíčová slova
• PLGA with papaverine hydrochloride coatings, break strength, dynamic frictional force, radiopacity, retention strength, ureteral stent,
• MeSH
• biokompatibilní materiály farmakologie   MeSH
• kopolymer kyseliny glykolové a mléčné farmakologie   MeSH
• lidé MeSH
• obstrukce močovodu metabolismus   chirurgie   terapie   MeSH
• papaverin metabolismus   farmakologie   MeSH
• polyurethany chemie   MeSH
• stenty uvolňující léky * MeSH
• vstřebatelné implantáty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biokompatibilní materiály MeSH
• kopolymer kyseliny glykolové a mléčné MeSH
• papaverin MeSH
• polyurethany MeSH

Bioresorbable stents are considered to be the 'fourth revolution' in percutaneous coronary intervention. The first clinically available Absorb(®) bioresorbable device is made of poly-l-lactic acid polymer and elutes everolimus. The process of bioresorption is completed in 3 years. The introduction of this device into clinical practice went through several logical phases: first-in-man studies, randomized Absorb II study with moderately complex patients and lesions, registries of real life patient population and reports of challenging cases. The procedural results are excellent; many insights have been gained by intracoronary imaging. Intermediate-term outcomes are very encouraging both from imaging and from clinical perspectives. The issue of increased stent thrombosis rate was raised in one study, but other studies have been reassuring. Excellent lesion preparation, sizing and complete expansion of the Absorb device are crucial for optimal procedural and clinical results. Results of ongoing large randomized studies will determine the future role of this technology.

• Klíčová slova
• Absorb®, bioresorbable stent, bioresorbable vascular scaffold, everolimus, percutaneous coronary intervention, poly-lactic acid,
• MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• nemoci koronárních tepen terapie   MeSH
• stenty uvolňující léky MeSH
• stenty * MeSH
• vstřebatelné implantáty * MeSH
• zobrazování trojrozměrné MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Biodegradable (BD) stents made from polydioxanone have been used only in human airways. These stents combine the advantages of classical tracheal stents, and fewer side effects are expected due to their biocompatibility and their time-limited presence in airways. However, new clinical consequences have arisen. Here, the authors share their experiences with BD stents for tracheal indications, focusing on their safety and efficacy. METHODS: This was a retrospective review of a collected database of adult patients who underwent implantation of biodegradable tracheal stents between September 2013 and December 2022 at the Department of Respiratory Medicine of the 1st Faculty of Medicine in Prague and Thomayer University Hospital. The indications included functionally significant nonmalignant tracheal stenosis and tracheomalacia. Self-expandable, biodegradable, polydioxanone tracheal stents manufactured by ELLA-CS Ltd. (Hradec Kralove, Czech Republic) were implanted during rigid bronchoscopy under general anaesthesia. All patients were followed up in the department and were provided with the necessary care. The main efficacy and safety parameters and relationships were analysed using descriptive statistics and Fisher´s exact, Wilcoxon and Kruskal‒Wallis tests. RESULTS: A total of 65 stents were implanted in 47 adult patients. During the first two months after implantation, when adequate function was expected, the stent was found to be effective in 26 out of 39 patients who completed this period (66.7%). The clinical effectiveness reached 89.7%, as early restenoses were mostly mild and necessitated treatment in only 4 patients. The frequencies of significant mucostasis, migration and granulation tissue growth were 2.6%, 7.5% and 23.1%, respectively, during this period. Thirty-four participants completed the half-year follow-up period after the first or second stent insertion, and some were followed up beyond this period. Poor control of symptoms, the development of restenosis and the need for interventions were characteristic of this period as the stents degraded. Twenty-two patients who experienced remodelling or stabilization of the tracheal lumen achieved a stent-free state. Seven patients underwent subsequent surgical treatment. CONCLUSIONS: BD stents are safe and provide adequate tracheal support until they begin to degrade. The use of BD stents necessitates close monitoring of patients and accurate treatment of possible restenosis. TRIAL REGISTRATION: Based on project NT14146 - Biodegradable stents in the management of the large airways (2013-2015, MZ0/NT), registered on May 1, 2013, in the Research and Development and Innovation Information System of the Czech Republic and at ClinicalTrials.gov (reg. no. NCT02620319, December 2, 2015).

• Klíčová slova
• Biodegradable, Bronchoscopy, Interventional pneumology, Polydioxanone, Stents, Tracheal stenosis,
• MeSH
• bronchoskopie * MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• polydioxanon MeSH
• protézy - design MeSH
• retrospektivní studie MeSH
• senioři MeSH
• stenóza průdušnice * chirurgie   MeSH
• stenty * MeSH
• trachea chirurgie   MeSH
• tracheomalacie chirurgie   MeSH
• vstřebatelné implantáty * MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: The aim of this prospective randomized noninferiority study was to compare the efficacy of paclitaxel-eluting balloon (PEB) catheters and everolimus-eluting stents (EES) in the treatment of bare metal stent restenosis. METHODS AND RESULTS: A total of 136 patients were enrolled in the study. Each treatment group included 68 patients with 74 in-stent restenotic lesions. The primary end point was in-segment late lumen loss (LLL) at 12 months. Secondary end points were the incidence of binary in-stent restenosis and 12-month major adverse cardiac events. The 2-sided 95% confidence interval of LLL difference between treatments (0.149-0.558) was greater than noninferiority margin (0.12), which demonstrates both noninferiority and superiority of PEB treatment. Furthermore, the PEB group had significantly less 12-month LLL than the EES group (0.02 versus 0.19 mm; P=0.0004). The difference in the incidence of repeated binary restenosis (8.7% versus 19.12%; P=0.078) and 12-month major adverse cardiac events (10.29% versus 19.12%; P=0.213) was not significant. The 12-month LLL was significantly less in the PEB group and also in subgroups with in-stent restenosis >10 mm (0.05 versus 0.26 mm; P=0.0002) and artery diameter <3 mm (0.05 versus 0.16 mm; P=0.003) compared with the EES groups, but not in the subgroup of patients with diabetes mellitus (P=0.254). In the EES group, repetitive binary restenosis had a significantly greater chance of occurring (odds ratio=3.132; 95% confidence interval, 1.058-9.269; P=0.039), even when adjusting for other risk factors. CONCLUSIONS: Treatment of bare metal stent restenosis using PEB led to significantly less 12-month LLL than the implantation of second-generation EES. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01735825.

• Klíčová slova
• coronary restenosis, diabetes mellitus, drug-eluting stents, paclitaxel, stents,
• MeSH
• biokompatibilní potahované materiály * MeSH
• časové faktory MeSH
• cévní přístupy * MeSH
• everolimus aplikace a dávkování   MeSH
• Kaplanův-Meierův odhad MeSH
• kardiovaskulární látky aplikace a dávkování   MeSH
• koronární angioplastika škodlivé účinky   přístrojové vybavení   MeSH
• koronární restenóza diagnostické zobrazování   etiologie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• nemoci koronárních tepen diagnostické zobrazování   terapie   MeSH
• odds ratio MeSH
• paclitaxel aplikace a dávkování   MeSH
• přežití po terapii bez příznaků nemoci MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• rizikové faktory MeSH
• rozdělení chí kvadrát MeSH
• senioři MeSH
• stenty uvolňující léky * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• biokompatibilní potahované materiály * MeSH
• everolimus MeSH
• kardiovaskulární látky MeSH
• paclitaxel MeSH

BACKGROUND: The COMBO drug eluting stent is a novel device with luminal endothelial progenitor cell capture technology for rapid homogeneous endothelialization. METHODS AND RESULTS: We examined for sex differences in 1-year outcomes after COMBO stenting from the COMBO collaboration, a pooled patient-level dataset from the MASCOT and REMEDEE multicenter registries. The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel-myocardial infarction (TV-MI), or clinically driven target lesion revascularization (CD-TLR). Secondary outcomes included stent thrombosis (ST). Adjusted outcomes were assessed using Cox regression methods. The study included 861 (23.8%) women and 2,753 (76.2%) men. Women were older with higher prevalence of several comorbidities including diabetes mellitus. Risk of 1-year TLF was similar in both sexes (3.8% vs. 3.9%, HR 0.92, 95% CI 0.59-1.42, p = .70), without sex differences in the incidence of cardiac death (1.6% vs. 1.5%, p = .78), TV-MI (1.5% vs. 1.1%, p = .32), or CD-TLR (2.0% vs. 2.2%, p = .67). Definite or probable ST occurred in 0.4% women and 1.0% men (HR 0.26, 95% CI 0.06-1.11, p = .069). CONCLUSIONS: Despite greater clinical risks at baseline, women treated with COMBO stents had similarly low 1-year TLF and other ischemic outcomes compared to men.

• Klíčová slova
• anti-CD34 antibodies, dual therapy stent, endothelial progenitor cell capture, percutaneous coronary intervention, sex differences,
• MeSH
• časové faktory MeSH
• koronární angioplastika * škodlivé účinky   MeSH
• lidé MeSH
• nemoci koronárních tepen * diagnostické zobrazování   chirurgie   MeSH
• pohlavní dimorfismus MeSH
• protézy - design MeSH
• rizikové faktory MeSH
• stenty uvolňující léky * MeSH
• stenty MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

The stents or stentgrafts (covered stents) are the medical instruments used in invasive radiology for miniinvasive treatment of stenosis and aneurisms especially in the blood circulation system. We measured and compared the mechanical parameters of different selfexpandable Nitinol stents, which differed in the geometry (radius and length), in the type of construction (number of branches and rising of winding) and in the diameter of the used wire. The results of measurements confirmed the theoretical assumptions that just the diameter of the Nitinol wire significantly influences the rigidity and the level of compressibility of the stent as well. The compromise must be found between the required rigidity of the stent and the minimal size of the delivery system. The exact description of the relation between the mechanical properties and geometry and construction of the stents enables us to design the stent to fit the patient's needs. The results of measurement are also necessary for the design and identification of the parameters of the models of the stents.

• MeSH
• design vybavení MeSH
• mechanický stres MeSH
• pevnost v tlaku MeSH
• slitiny * MeSH
• stenty * MeSH
• teplota MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• nitinol MeSH Prohlížeč
• slitiny * MeSH

Stent designs with ultrathin struts may further increase the procedural success of challenging lesion subsets. The objective of this study was to assess the safety and efficacy of ultrathin strut, polymer-free sirolimus eluting stent (PF-SES) implantations in a large scale, unselected patient population.Adult patients underwent percutaneous coronary interventions (PCI) with a thin-strut PF-SES. Data from two all-comers observational studies having the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were pooled. The accumulated target lesion revascularization (TLR) rate at 9-12 months was the primary endpoint. All dual antiplatelet therapy strategies according to the applicable guidelines were permissible.In total, 7243 patients were prospectively enrolled for PCI with PF-SES in stable coronary artery disease or acute coronary syndrome (ACS). Major risk factors in the overall cohort were diabetes (37.3%), ST elevation myocardial infarction (18.1%) and non-ST myocardial infarction (24.6%). The follow-up rate was 88.6% in the overall population. The TLR rate in the overall cohort was 2.2% whereas definite/probable stent thrombosis (ST) occurred in 0.7%. In patients with in-stent restenosis lesions, the major adverse cardiac events rate was 6.4% whereas the corresponding rate for isolated left main coronary artery (LMCA) disease was highest with 6.7% followed by patients with culprit lesions in vein bypasses (VB, 7.1%). The mortality rate in patients treated in VB lesions was highest with 5.4%, followed by the isolated LMCA subgroup (3.4%) and ACS (2.6%).PCI with PF-SES in an unselected patient population, is associated with low clinical event and ST rates. Furthermore, PF-SES angioplasty in niche indications demonstrated favorable safety and efficacy outcomes with high procedural success rates.

• MeSH
• akutní koronární syndrom diagnóza   mortalita   chirurgie   MeSH
• antibakteriální látky terapeutické užití   MeSH
• cévy - implantace protéz metody   MeSH
• diabetes mellitus epidemiologie   MeSH
• infarkt myokardu bez ST elevací komplikace   epidemiologie   MeSH
• infarkt myokardu s elevacemi ST úseků komplikace   epidemiologie   MeSH
• koronární angioplastika přístrojové vybavení   MeSH
• lékařská praxe - způsoby provádění normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci koronárních tepen diagnóza   mortalita   chirurgie   MeSH
• okluze cévního štěpu epidemiologie   MeSH
• polymery MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• rizikové faktory MeSH
• senioři MeSH
• sirolimus terapeutické užití   MeSH
• stenty uvolňující léky škodlivé účinky   trendy   MeSH
• vstřebatelné implantáty škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• pozorovací studie MeSH
• Názvy látek
• antibakteriální látky MeSH
• polymery MeSH
• sirolimus MeSH

The aim of this study was to analyze the possibilities of various types of stent modeling and to develop some new models. A brief survey of basic properties of stents and a list of basic designs of stents is presented. Two approaches to stent modeling were identified. Structural mechanics is the theoretical background of our analytical model of a spiral stent. The finite element method was also used. The measurement equipment for model evaluation was developed.

• MeSH
• analýza metodou konečných prvků MeSH
• časové faktory MeSH
• mechanický stres MeSH
• počítačová simulace MeSH
• protézy - design MeSH
• selhání protézy MeSH
• stenty * MeSH
• teoretické modely * MeSH
• testování materiálů MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Bioresorbable Vascular Scaffolds (BVS) are polymer-based materials implanted in the coronary arteries in order to treat atherosclerotic lesions, based on the concept that once the lesion has been treated, the material of the implanted stent will undergo a process of gradual resorption that will leave, in several years, the vessel wall smooth, free of any foreign material and with its vasomotion restored. However, after the first enthusiastic reports on the efficacy of BVSs, the recently published trials demonstrated disappointing results regarding long-term patency following BVS implantation, which were mainly attributed to technical deficiencies during the stenting procedure. Intracoronary imaging could play a crucial role for helping the operator to correctly implant a BVS into the coronary artery, as well as providing relevant information in the follow-up period. This review aims to summarize the role of intracoronary imaging in the follow-up of coronary stents, with a particular emphasis on the role of intravascular ultrasound and optical coherence tomography for procedural guidance during stent implantation and also for follow-up of bioabsorbable scaffolds.

• Klíčová slova
• Coronary stents, bioresorbable, intracoronary imaging, polymer-coated stent, stent struts, vascular scaffold.,
• MeSH
• lidé MeSH
• následné studie MeSH
• protézy - design MeSH
• stenty uvolňující léky * MeSH
• stenty MeSH
• vstřebatelné implantáty * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Biodegradable stents that disintegrate after a period of time are expected to be well tolerated and have advantages over other stents that are more commonly used in practice today. Polydioxanone is a biodegradable polymer that is widely used during surgery with absorbable sutures. METHODS: We present cases from the first four patients to undergo a tracheal polydioxanone stent insertion. Indications included significant non-malignant tracheal stenosis in cases where primary surgical treatment was not possible. The stents were implanted using rigid bronchoscopy and patients received regular follow-ups as needed. This use of biodegradable stents in adult patients was a novel, previously untested approach. The study was approved by the Institutional Ethics Committee and was based on a project entitled; "Biodegradable stents in the management of stenoses of large airways" (project NT 14146-3/2013). RESULTS: Six biodegradable stents were implanted in four patients with benign stenoses. No technical difficulties occurred and no serious or life-threatening events were recorded. All patients reported some benefit from treatment. CONCLUSION: Polydioxanone tracheal stents can be considered when a need for temporary support is expected, and as an alternative to other stents if the latter could compromise the patient. Owing to limited experience and observed disadvantages, further research is needed to fully assess this treatment. TRIAL REGISTRATION: This work is based on project NT14146 - Biodegradable stents in the management of stenoses of the large airways (2013-2015, MZ0/NT), registered from May 1, 2013 in The Research and Development and Innovation Information System of the Czech Republic and in ClinicalTrials.gov, reg. no. NCT02620319, December 2, 2015.

• MeSH
• biokompatibilní materiály chemie   MeSH
• bronchoskopie MeSH
• lidé středního věku MeSH
• lidé MeSH
• polydioxanon chemie   MeSH
• senioři MeSH
• stenóza průdušnice chirurgie   MeSH
• stenty klasifikace   MeSH
• trachea chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• biokompatibilní materiály MeSH
• polydioxanon MeSH