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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ENanomaterials are materials in which 50% or more of the contained particles are in the range of 1 nm to 100 nm. They have several potential clinical applications, including antithrombotic therapy, cell therapy, treatment of atherosclerosis, drug delivery, and nanorods for induction of angiogenesis. This article discusses the targets and therapies of nanotechnology, next-generation ventricular assist devices, drug-coated balloons and bioabsorbable stents.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ENanomaterials are materials in which 50% or more of the contained particles are in the range of 1 nm to 100 nm. They have several potential clinical applications, including antithrombotic therapy, cell therapy, treatment of atherosclerosis, drug delivery, and nanorods for induction of angiogenesis. Sanjay Misra, MD, Mayo Clinic, Rochester, Minnesota, USA, discussed the targets and therapies of nanotechnology.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EKaragkiozaki et al. [\u003Cem\u003EInt J Nanomedicine\u003C\/em\u003E 2010] found that the surface nanotopography of stent nanocoating influences the behavior of platelets, and this is a key factor for biomaterial thrombogenicity Patra et al. [\u003Cem\u003ENano Lett\u003C\/em\u003E 2011] demonstrated that europium hydroxide nanorods (inorganic nanorods) with a diameter of 35 nm to 50 nm and a length of 200 nm to 300 nm cause an increase in proangiogenic cytokines, such as vascular endothelial growth factor-A and basic fibroblast growth factor.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EVarious nanoscale technologies are being applied to the field of stem cell therapy for the treatment of cardiovascular diseases. Other promising applications include the prevention, imaging, and treatment of atherosclerosis [Psarros C et al. \u003Cem\u003ENanomedicine\u003C\/em\u003E 2012] and the use of copolymer-stabilized micro- and nanobubbles as vectors for the anticancer drug doxorubicin [Rapoport N et al. \u003Cem\u003EJ Natl Cancer Inst\u003C\/em\u003E 2007]. Valenzuela and Simon [\u003Cem\u003ENanomedicine\u003C\/em\u003E 2012] describe a micellar estradiol formulation that serves as an alternative transdermal delivery system for hormone replacement therapy. According to Dr. Misra, nanotechnologies have far reaching implications for the practice of medicine in a wide range of fields.\u003C\/p\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ENext-Generation Ventricular Assist Devices\u003C\/h2\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EMark S. Slaughter, MD, University of Louisville, Louisville, Kentucky, USA, presented information on next-generation ventricular assist devices (VADs), heart valves, and other devices. All of the products he discussed are in various stages of development, and none are FDA-approved.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EAs VAD technology evolves it is increasingly being applied as destination therapy rather than exclusively as a bridge to transplant. Kirklin et al. [\u003Cem\u003EJ Thorac Cardiovasc Surg\u003C\/em\u003E 2012] reported that the average 2-year survival after cardiac transplantation is \u223c80%. However, evolution from pulsatile to continuous flow technology has dramatically improved 1- and 2-year survival, and important subsets of patients with continuous flow destination therapy now enjoy survival that is comparable with heart transplantation out to 2 years. After discussing a breakthrough technology that delivers nitric oxide from a novel liquid source, he said that new VAD technology should reduce operative trauma, thus reducing overall adverse events.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ENext-Generation Valves and Devices\u003C\/h2\u003E\n         \u003Cp id=\u0022p-7\u0022\u003ENext-generation valve companies are making use of the small intestine submucosa-extracellular matrix (SIS-ECM) to improve their products and potentially improve postoperative outcomes. CorMatrix Cardiovascular is testing tissue-engineered ECM for pericardial repair; the product comes from porcine-derived SIS.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003ESIS-ECM is obtained from the submucosa of the small intestine of pigs and consists of a complex matrix of collagen; the submucose is found between the mucosal and muscular layers of the small intestine. It provides strength to the intestine and also serves as a reservoir for cytokines that support the growth and differentiation of intestinal epithelial cells.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003ETransapical aortic valve implantation has evolved as a treatment option for high-risk patients who have severe aortic stenosis. While much of the focus has been on improving valves and the delivery systems, issues of vascular access and safe closure remain important and of great interest.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EDr. Slaughter reported that a first-in-human clinical trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01721642\u0026amp;atom=%2Fspmdc%2F12%2F18%2F28.atom\u0022\u003ENCT01721642\u003C\/a\u003E] of the Apica ASC transapical access and closure device had successful access and closure, with no device-related complications to date.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EDr. Slaughter said that natural scaffolds that repopulate with native cells might fix the problem of durability of bioprosthetic valves; that safe, reliable, and near bloodless access to the LV apex could improve outcomes and approach to both aortic and mitral valve replacements; that the ability to deliver a predetermined dose of cells\/matrix to a specific area could improve clinical efficacy of regenerative medicine; and that new delivery systems for nitric oxide could allow chronic treatment in patients who are not candidates for other therapies.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EDrug-Coated Balloons and Bioabsorbable Stents\u003C\/h2\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EBruno Scheller, MD, Universit\u00e4tsklinikum des Saarlandes, Homburg\/Saar, Germany, focused on drug-coated balloons and bioabsorbable stents\u2014vascular restoration therapy, ie, the fourth revolution in interventional cardiology, according to Wykrzykowska et al [\u003Cem\u003EEuroIntervention\u003C\/em\u003E 2009].\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003ELong-term (\u0026gt;10 years) clinical outcomes of a first-in-human study of a fully biodegradable poly-l-lactic acid coronary stent found rates free of all-cause death, cardiac death, and major adverse cardiac events at 10 years of 87%, 98%, and 50%, respectively [Nishio S et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2012]. Intravascular ultrasound data suggest that the stent struts mostly disappear within 3 years. The external elastic membrane area and stent area did not change.\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EABSORB Clinical Investigation, Cohort B [ABSORB B; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00856856\u0026amp;atom=%2Fspmdc%2F12%2F18%2F28.atom\u0022\u003ENCT00856856\u003C\/a\u003E], a multicenter, single-arm trial, assessed the safety and performance of an everolimus-eluting bioresorbable vascular scaffold [Ormiston JA et al. \u003Cem\u003ECirc Cardiovasc Interv\u003C\/em\u003E 2012]. Forty-five patients underwent serial invasive imaging at 6 and 24 months of follow-up. Struts still recognizable on optical coherence tomography at 2 years showed 99% neointimal coverage with optical and ultrasonic signs of bioresorption accompanied by an increase in mean scaffold area compared with baseline. The 2-year major cardiac event rate was 6.8% without any scaffold thrombosis, confirming the medium-term safety and efficacy of the new device. However, randomized controlled clinical trials are missing for bioabsorbable stents.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EDrug-coated balloon catheters have been studied in a variety of randomized studies and large registries, especially paclitaxel-iopromide- and paclitaxel-urea coated balloons. For patients with peripheral artery disease, a meta-analysis of randomized trials compared target lesion revascularization using paclitaxel-coated balloon angioplasty versus conventional uncoated balloon angioplasty showed superior antirestenotic efficacy compared with uncoated balloon angioplasty (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E) [Cassese S et al. \u003Cem\u003ECirc Cardiovasc Interv\u003C\/em\u003E 2012]. Other studies in coronary arteries have had similar findings in the treatment of in-stent restenosis and de novo lesions [Unverdorben M et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2009; W\u00f6hrle J et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2012]. Dr. Scheller said that drug-coated balloons are not a replacement for drug-eluting stents, but a new option in endovascular and coronary interventions and potentially useful in areas of the leg where stenting is typically avoided due to joint motion. Both drug-coated balloons and bioabsorbable stents represent the technology for a new age of vascular therapy that leaves no permanent implants behind.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/13101\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/13101\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13101\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-16\u0022 class=\u0022first-child\u0022\u003ETarget Lesion Revascularization.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/18\/28.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn6n1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzn6n1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}