Wingspan Stenting for Intracranial Atherosclerotic Stenosis: Clinical Outcomes and Risk Factors for in-Stent Restenosis.

Wingspan Stenting for Intracranial Atherosclerotic Stenosis: Clinical Outcomes and Risk Factors for In-stent Restenosis.

Filed under: Drug and Alcohol Rehabilitation

Neurosurgery. 2012 Dec 28;
Shin YS, Kim BM, Suh SH, Jeon P, Kim DJ, Kim DI, Kim BS, Kim KH, Heo M D JH, Nam HS, Kim YD

BACKGROUND:: Intracranial atherosclerotic stenosis (ICAS) is responsible for 9-37% of ischemic strokes. OBJECTIVE:: To evaluate the clinical outcome and risk factors for in-stent restenosis (ISR) after treatment of ICAS with a Wingspan stent. METHODS:: Seventy-seven patients with 79 total target ICAS > 60% (mean, 79.9 ± 8.4%; symptomatic ICAS, 96.2%) underwent attempted treatment with Wingspan stenting between March 2010 and March 2011. A retrospective review of the prospectively registered data was conducted to assess the risk factors for ISR as well as the clinical outcomes of these patients. RESULTS:: The 30-day TIA/stroke and death rates were 5.3% (95% CI, 0.1% to 10.5%) and 0%, respectively. All patients but one were followed clinically for a mean of 18.9 months (range, 12-23 months). During the period, cumulative TIA/stroke and death rates were 8.1% (95% CI, 1.7% to 14.5%) and 0%, respectively. Only one patient suffered a disabling stroke (subarachnoid hemorrhage), which was associated with retreatment of an ISR using a drug-eluting balloon-expandable stent. Follow-up angiography was available in 69 treated vessels (89.6%) at 3-24 months (median: 12 months). Binary ISR rate was 24.6%, of which 17.6% (3 of 17 cases) were symptomatic. Rapid balloon inflation (95% CI, 5.490 to 530.817) and longer length of stenosis (95% CI, 1.093 to 1.891) were independent risk factors for ISR. CONCLUSION:: Wingspan stenting may be effective for appropriately selected ICAS patients. Rapid balloon inflation and longer lengths of stenosis were independent risk factors for ISR.
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Metabolism of Saikosaponin a in Rats: Diverse Oxidations on the Aglycone Moiety in Liver and Intestine Besides Hydrolysis of Glycosidic Bonds.

Filed under: Drug and Alcohol Rehabilitation

Drug Metab Dispos. 2012 Dec 31;
Liu G, Tian Y, Li G, Xu L, Song R, Zhang Z

The main objective of the present study was to completely characterize the metabolites of the triterpenoid saikosaponin a (SSa) in rats. To this aim, we compared the metabolites in the plasma, bile, urine and feces samples following oral and intravenous routes of administration using liquid chromatography-diode array detector coupled with hybrid ion trap-time of flight-mass spectrometry (LC-DAD-IT-TOF-MS). As a result, besides two known metabolites, prosaikogenin f (PSGf)and saikogenin f (SGf), fifteen new metabolites were detected in all. It was found that SSa is metabolized mainly in phase I manner, i.e., hydration and mono-oxidation on the aglycone moiety and hydrolysis of ?-glucosidic bond in the liver while sequential hydrolysis of ?-glucosidic and ?-fucosidic bonds followed by dehydrogenation, hydroxylation, carboxylation and combinations of these steps on the aglycone moiety in the intestinal tract. Both the renal and billiary routines were observed for the excretion of SSa and its metabolites. Further, a clear metabolic profile in rats was proposed in detail according to the results from the in vivo animal experiment after different routes of administration. Our results update the preclinical metabolism and disposition information of SSa, which is not only helpful in the future human metabolic study of this compound but also provides basic information for better understanding the efficacy and safety of prescriptions containing saikosaponins.
HubMed – drug


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