Enabling Angioplasty-Ready “Smart” Stents to Detect In-Stent Restenosis and Occlusion

MedicalResearch.com Interview with:

Kenichi Takahata, Ph.D., P.Eng. Associate Professor Department of Electrical & Computer Engineering Faculty of Applied Science University of British Columbia Vancouver, B.C., Canada

Dr. Takahata

Kenichi Takahata, Ph.D., P.Eng.
Associate Professor
Department of Electrical & Computer Engineering
Faculty of Applied Science
University of British Columbia
Vancouver, B.C., Canada

MedicalResearch.com: What is the background for this technology and study? 

Response: Cardiovascular disease (CVD) is the number one cause of mortality globally. One of the most common and proven treatments for CVD is stenting. Millions of stents are implanted annually worldwide. However, the most common complication called in-stent restenosis, re-narrowing of stented arteries, still poses a significant risk to patients.

To address the current lack of diagnostic technology to detect restenosis at its early stage, we are developing “smart” stents equipped with microscale sensors and wireless interface to enable continuous monitoring of restenosis through the implanted stent. This electrically active stent functions as a radio-frequency wireless pressure transducer to track local hemodynamic changes upon a re-narrowing condition. We have reported a new smart stent that has been engineered to fulfill clinical needs for the implant, including its applicability to current stenting procedure and tools, while offering self-sensing and wireless communication functions upon implantation.

The stent here has been designed to function not only as a typical mechanical scaffold but also as an electrical inductor or antenna. To construct the device, the custom-designed implantable capacitive pressure sensor chip, which we developed using medical-grade stainless steel, are laser-microwelded on the inductive antenna stent, or “stentenna”, made of the same alloy. This forms a resonant circuit with the stentenna, whose resonant frequency represents the local blood pressure applied to the device and can be wirelessly interrogated using an external antenna placed on the skin.

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Readmissions After Stent Surgery Common and Often Due to Co-Morbid Disease

MedicalResearch.com Interview with:

“Open Stent” by Lenore Edman is licensed under CC BY 2.0

Example of Open Cardiac Stent

Chun Shing Kwok, MBBS, MSc, BSc, MRCP(UK)
Clinical Lecturer in Cardiology and Specialist Registrar in Cardiology
Keele University & Royal Stoke University Hospital Guy Hilton Research 

MedicalResearch.com: What is the background for this study?

Response: Percutaneous coronary intervention (PCI) is a common revascularization modality in the treatment for coronary heart disease and the mortality rate after this procedure is low. Improved survival after PCI procedures has led to a growing population at risk of readmissions.  Early unplanned readmissions are important because they are a burden to patients, the local health care economy and it also serves as a quality of care indicator.

MedicalResearch.com: What are the main findings?

Response: Our analysis of 833,344 PCI procedures in the United States demonstrates that unplanned readmissions within 30 days of the index PCI are common (9.3%). The mean total hospital cost was higher for patients who were readmitted compared with those not readmitted ($37,524 vs $23,211). The majority of readmissions within 30 days are noncardiac (56%), with female sex, chronic kidney disease, liver failure, atrial fibrillation, increasing comorbidity burden, and discharge location among the strongest predictors of unplanned 30-day readmission. Patients who experienced an unplanned readmission for noncardiac reasons tended to be younger, with more comorbidities, including alcohol misuse, cancer, and dementia, whereas patients who are readmitted for cardiac reasons are more likely to have in-hospital complications at their index PCI event. 

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest that 30-day readmissions in the United States is common and comorbid illnesses and places of discharge are important factors that influence readmissions. There are important financial consequences of such readmissions, and further strategies to reduce the prevalence should be explored. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future work should explore if optimization of the management of any comorbid condition during a patient’s index admission for PCI and outreach programs to patients discharged to short-term hospitals, other institutions, and care homes may reduce early readmissions. 

Disclosures: Financial support was provided by the North Staffs Heart Committee. This work was conducted as a part of Dr. Kwok’s PhD research, which was supported by Biosensors International. 

Citations: 

Kwok CS, Rao SV, Potts JE, et al. Burden of 30-day readmissions after percutaneous coronary intervention in 833,344 patients in the United States: predictors, causes, and cost insights from the Nationwide Readmission Database. J Am Coll Cardiol Intv. 2018;Epub ahead of print.

Kalra A, Shishehbor MH, Simon DI. Percutaneous coronary intervention readmissions: where are the solutions? J Am Coll Cardiol Intv. 2018;Epub ahead of print.

 

 

 

 

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