Drug eluting stents may not be the answer for myocardial bridges

Rondán, Juan; Lozano, Íñigo; Avanzas, Pablo; Palop, Ramón Lopéz; Vegas, José M.; Morís, César

doi:10.1016/j.ijcard.2006.11.158

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…Although coronary stenting was shown to abolish ischemic symptoms, we found a high rate of in-stent restenosis with bare metal stents deployed in segments with MB [6]. This finding was supported by other studies including drug eluting stents [7,8]. We speculated that in-stent restenosis which were diffuse in most of the patients might have been due to vasoactive substances released from the vessel wall squeezed between the stent and the myocardium in each contraction, so called "sandwich effect" [6].…”

supporting

confidence: 88%

Coronary myocardial bridge constitutes a risk: But how to manage it?

Barçın¹,

Kurşaklıoğlu²,

Köse³

et al. 2010

International Journal of Cardiology

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supporting

confidence: 88%

Coronary myocardial bridge constitutes a risk: But how to manage it?

Barçın¹,

Kurşaklıoğlu²,

Köse³

et al. 2010

International Journal of Cardiology

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“…Even though coronary stent is capable of suppressing ischemic symptoms, there is a high rate of in-stent restenosis with stents implanted in segments with myocardial bridge [40]. This finding was corroborated by other studies, including pharmacological stents [41,42]. It is speculated that the in-stent restenosis, which was diffuse in most patients, may be due to vasoactive substances released from the vessel wall, squeezed between the stent and the myocardium, at each contraction [40].…”

Section: Clinical-surgical Implicationsmentioning

confidence: 53%

Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias

Ramalli¹,

Braga²,

Évora³

et al. 2011

Rev Bras Cir Cardiovasc

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Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias: um mistério a ser resolvido?Absence of arteriosclerosis in intramyocardial coronary arteries: a mystery to be solved? Work AbstractSeveral studies show that portions of intramyocardial coronary arteries are spared of arteriosclerosis, involving morphological, embryological, biochemical and pathophysiological aspects. Endothelial function is significantly affected in the segment of transition, as estimated by the vasoactive response to Ach. These findings suggest that myocardial bridge can provide protection against arteriosclerosis by counteracting the negative effects of endothelial dysfunction. The intramyocardial portion's protection phenomenon deserves further scientific research on all research fronts. Improved morphological, biomechanical and especially physiological and embryological knowledge may be the key to a future window of opportunity for chronic arterial disease therapy and prevention. In addition, this review discusses possible therapeutic approaches for symptomatic coronary ischemia caused by myocardial bridges.Descriptors: Myocardial bridging. Coronary circulation. Endothelium. ResumoDiversos estudos demonstram que as porções intramiocárdicas das artérias coronárias são poupadas da arteriosclerose, envolvendo aspectos morfológicos, embriológicos, biomecânicos e aspectos fisiopatológicos. A função endotelial é significativamente afetada no segmento de transição, tal como estimado pela resposta vasoativa para acetilcolina (Ach). Esses achados sugerem que ponte miocárdica pode fornecer proteção contra a arteriosclerose, por contrariar os efeitos negativos da disfunção endotelial. O fenômeno dessa proteção da porção intramiocárdica merece maior investigação científica em todas as frentes de pesquisa. Maiores conhecimentos sobre os aspectos morfológicos, biomecânicos e, principalmente, fisiológicos e embriológicos podem ser a chave para uma futura janela de oportunidades de terapia e prevenção da doença arterial crônica. Nessa revisão, discutemse, também, possíveis abordagens terapêuticas para fenômenos coronarianos isquêmicos causados por pontes miocárdicas.Descritores: Ponte miocárdica. Circulação coronária. Endotélio. RBCCV 44205-1301

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“…This view may not be shared by all cardiologists [ 38 , 39 ] because one can object that the stent is implanted in such a manner as to cover also the whole tunneled segment. But stenting of bridges was shown to be associated with high restenosis rates [ 5 , 40 - 42 ]. Thus, it might turn out in the future that only surgery can suppress both ischemia and the progression of atherosclerosis in the proximal epicardial segment.…”

Section: Discussionmentioning

confidence: 99%

Could increased axial wall stress be responsible for the development of atheroma in the proximal segment of myocardial bridges?

Doriot¹,

Dorsaz²,

Noble³

2007

Theor Biol Med Model

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Background: A recent model describing the mechanical interaction between a stenosis and the vessel wall has shown that axial wall stress can considerably increase in the region immediately proximal to the stenosis during the (forward) flow phases, so that abnormal biological processes and wall damages are likely to be induced in that region. Our objective was to examine what this model predicts when applied to myocardial bridges.

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Drug eluting stents may not be the answer for myocardial bridges

Cited by 7 publications

References 10 publications

Coronary myocardial bridge constitutes a risk: But how to manage it?

Coronary myocardial bridge constitutes a risk: But how to manage it?

Ausência de arteriosclerose na porção intramiocárdica das artérias coronárias

Could increased axial wall stress be responsible for the development of atheroma in the proximal segment of myocardial bridges?

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