What are recent advances in treatments of angina?5 answersRecent advances in the treatment of angina encompass a variety of innovative approaches. Novel antithrombotic agents have been developed to target local thrombosis following atherosclerotic plaque rupture. Small-molecule therapies are emerging as promising options for managing angina in the elderly population, emphasizing the need for individualized treatment strategies. For refractory angina, which poses a significant clinical challenge, ongoing research focuses on novel therapies targeting myocardial ischemia, including gene therapy, stem cell therapy, and transmyocardial laser revascularization. Additionally, advancements in coronary artery disease treatment involve interdisciplinary collaborations leading to strategies like stem cells, nanotechnology for drug delivery, and robotic surgery, offering effective alternatives to traditional approaches. These diverse advancements highlight a shift towards personalized and cutting-edge therapies for angina management.
What is fatigue of structural materials?3 answersFatigue of structural materials refers to the phenomenon of damage accumulation and failure in metal structures when they are subjected to fluctuating stresses or strains. This type of failure is prevalent in engineering components made from metals and alloys, and it occurs due to the repetitive cyclic loading experienced by these components. Fatigue can lead to crack initiation and propagation, which can significantly reduce the lifetime of the structure. Factors such as applied material type, environment temperature, microstructure state, residual stress, corrosion, and crack initiation can affect the fatigue resistance of structural materials. To ensure the reliability and service life of metal structures, it is important to analyze and understand their fatigue behavior, including the estimation of fatigue life and the assessment of stress concentrations in critical areas such as welds.
Are drug eluting stents helpful to treat MI?5 answersDrug-eluting stents (DES) have been developed as a treatment for peripheral arterial disease and coronary heart disease. They have shown success in reducing revascularization rates and improving clinical outcomes in both conditions. DESs inhibit vascular smooth muscle cell proliferation and migration through the use of pharmaceutical agents such as paclitaxel and sirolimus. Newer generation DES have been developed to improve safety and efficacy, with thinner stent struts and sustained drug release. DESs have been associated with a sustained reduction in cardiac death or myocardial infarction, lower risk of stent thrombosis, and reduced need for repeat revascularization compared to bare-metal stents. However, the superiority of DESs over bare-metal stents for treating saphenous vein graft lesions has not been well-established. Overall, DESs have shown promise in improving outcomes for peripheral arterial disease and coronary heart disease, but further research is needed to fully understand their effectiveness in different patient populations and lesion types.
What is the state of the art method for stent fatigue assesment?5 answersThe state of the art method for stent fatigue assessment involves a combination of experimental testing and computational simulations. Experimental accelerated durability testing is conducted to evaluate the risk of fatigue fractures in cardiovascular implants. Computational simulations are then used to calculate fatigue safety factors (FSFs) based on different methods. The tensor method and the modified tensor method consistently predicted fracture or survival under axial fatigue loading, while the scalar method showed limitations and potential inaccuracies. For Ni-Ti stents, critical plane-based criteria were found to be more representative of experimental outcomes for fatigue strength assessment, compared to the von Mises yield criterion. In the case of self-expanding Nitinol stents, a comprehensive finite element analysis (FEA) framework considering physiological deformation and atherosclerotic plaque was shown to be necessary for accurate evaluation of stent fatigue behaviors. A global computational design method combining mechanical finite element analysis and a novel multiaxial fatigue criterion was proposed for preclinical validation of Nitinol stents.
Is drug-coated balloon useful for severe calcified coronary artery disease?5 answersDrug-coated balloon (DCB) treatment has shown promise in the management of severe calcified coronary artery disease. Studies have reported the efficacy of DCB in combination with other interventions such as orbital atherectomy (OA) and intravascular lithotripsy (IVL). In a study evaluating the long-term outcomes of DCB-only treatment for de novo lesions with and without coronary artery calcification (CAC), it was found that CAC increased the incidence of target lesion failure (TLF) and target lesion revascularization (TLR) without a substantial increase in the risk of major adverse cardiac events (MACE), cardiac death, myocardial infarction (MI), or any revascularization. Another study demonstrated that DCB treatment after rotational atherectomy (RA) was safe and effective in selected patients with severe CAC. These findings suggest that DCB may be a useful treatment option for severe calcified coronary artery disease, but further research is needed to establish its optimal role in this patient population.
Why is polylactic acid so widely used as a material for bioabsorbable stents?5 answersPolylactic acid (PLA) is widely used as a material for bioabsorbable stents due to its biocompatibility, biodegradability, and tailorable properties. PLA is a degradable and environmentally friendly polymer that has good physical properties and is approved by the U.S. Food and Drug Administration (FDA) as a biomedical material. It can be easily metabolized by the body without eliciting critical responses. PLA-based polymers have well-established processing technologies, making them suitable for various biomedical applications, including stent coating. PLA stents have been developed for different organs, such as the gastrointestinal tract, and have shown promise in overcoming technical limitations. The use of PLA in nanomedicine has also emerged as a promising application, particularly in the synthesis of nanocarriers for targeted drug delivery. Overall, the combination of PLA's biocompatibility, biodegradability, and processing capabilities makes it a widely used material for bioabsorbable stents.