Background-Stent implantation for obstructive femoropopliteal artery disease has been associated with poor long-term outcomes. This study evaluated the effectiveness of shape memory alloy recoverable technology (SMART) nitinol self-expanding stents coated with a polymer impregnated with sirolimus (rapamycin) versus uncoated SMART stents in superficial femoral artery obstructions. Methods and Results-Thirty-six patients were recruited for this double-blind, randomized, prospective trial. All patients had chronic limb ischemia and femoral artery occlusions (57%) or stenoses (average lesion length, 85Ϯ57 mm). Patients were eligible for randomization after successful guidewire passage across the lesion. Eighteen patients received sirolimus-eluting SMART stents and 18 patients received uncoated SMART stents. The primary end point of the study was the in-stent mean percent diameter stenosis, as measured by quantitative angiography at 6 months. The in-stent mean percent diameter stenosis was 22.6% in the sirolimus-eluting stent group versus 30.9% in the uncoated stent group (Pϭ0.294). The in-stent mean lumen diameter was significantly larger in the sirolimus-eluting stent group (4.95 mm versus 4.31 mm in the uncoated stent group; Pϭ0.047). No serious adverse events (death or prolonged hospitalization) were reported. Conclusions-The use of sirolimus-eluting SMART stents for superficial femoral artery occlusion is feasible, with a trend toward reducing late loss compared with uncoated stents. The coated stent also proved to be safe and was not associated with any serious adverse events.

Conversion from CNI-based immunosuppression to MMF and Sir in HTx patients with chronic renal failure was safe, preserved graft function, and improved renal function.

Activated layered double hydroxides (LDHs) with high crystallinity, obtained by calcination/rehydration of LDH precursors synthesized by urea decomposition, have higher catalytic activity in acetone self‐condensation and Knoevenagel reactions than less crystalline materials obtained from LDH precursors synthesized by titration co‐precipitation. The activated LDHs possess both basic and acidic sites. High resolution transmission electron microscopy (HRTEM) confirms that the highly crystalline activated LDHs retain the lattice structure of the LDH precursors with lattice parameters a = b = 0.31 ± 0.01 nm and α = 60 ± 2°. An acid‐base catalytic mechanism has been proposed to interpret the catalytic behavior based on the fact that acid‐base hydroxyl group pairs on the activated LDH surface have a separation of 0.31 nm. It is proposed that the active sites are mainly located on the ordered array of hydroxyl sites on the basal surfaces rather than on the edges, as has been previously suggested. © 2007 American Institute of Chemical Engineers AIChE J, 2007