title: Rationale and results of percutaneous coronary revascularization with endothelial progenitor cell capture stent in high-risk patients requiring undeferrable non-cardiac surgery.
abstract: OBJECTIVE
  Drug eluting stents (DES) are currently the gold standard for the treatment of significant coronary artery stenosis in high risk patients. In case of undeferrable non-cardiac surgery their use is still a challenge, due to the need of a prolonged dual antiplatelet therapy. We aimed to prospectively evaluate the efficacy and safety of the implantation of endothelial progenitor cells (EPC) capture stent followed by a short dual anti-platelet therapy (DAT) period in a high risk population of patients undergoing undeferrable non-cardiac surgery.
  
  
  METHODS
  We examined all consecutive patients who received EPCs capture stents and underwent non-cardiac surgery within 60 days of percutaneous coronary intervention. Our primary outcome was the occurrences of cardiac death, myocardial infarction (MI), stent thrombosis (ST), target vessel revascularization (TVR) and major adverse cardiac events (MACE).
  
  
  RESULTS
  Twenty-six patients underwent PCI and were enrolled, but only 20 underwent surgical intervention. Technical and procedural success rates were both 100%. No perioperative MACE was detected. After a mean long term follow-up of 15.4±10.3 months, 2 cases of cardiac death (10%), were recorded. No case of stent thrombosis was reported; no case of ischemia driven TLR was detected. The total MACE-free survival probability was 66.5%.
  
  
  CONCLUSIONS
  EPC capture stent implantation in high-risk patients requiring undeferrable non-cardiac surgery seems to allow early cand safe discontinuation of DAT, and may be an attractive alternative to conventional stents.
authors: Department of Cardiovascular and Thoracic Diseases, S. Giovanni Battista University Hospital, Turin, Italy. paolo.scacciatella@tin.it
authors: P
authors: P
authors: Scacciatella
authors: M
authors: M
authors: D'Amico
authors: I
authors: I
authors: Meynet
authors: M
authors: M
authors: Pennone
authors: F
authors: F
authors: Conrotto
authors: G
authors: G
authors: Amato
authors: V
authors: V
authors: Frisenda
authors: E
authors: E
authors: Pelloni
authors: S
authors: S
authors: Marra
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D042783:Endothelial Cells; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013234:Stem Cells; D015607:Stents / Q000009:adverse effects*; D013514:Surgical Procedures, Operative
chemical_list: D010975:Platelet Aggregation Inhibitors