SPIRIT Women, evaluation of the safety and efficacy of the XIENCE V everolimus-eluting stent system in female patients: referral time for coronary intervention and 2-year clinical outcomes

SPIRIT Women is the first interventional trial dedicated exclusively to women, focusing on symptoms at presentation, referral time to coronary intervention and the safety and performance of the XIENCE V stent.

The edge vascular response following implantation of the Absorb everolimus-eluting bioresorbable vascular scaffold and the XIENCE V metallic everolimus-eluting stent. First serial follow-up assessment at six months and two years: insights from the first-in-man ABSORB Cohort B and SPIRIT II trials

AIMS To assess serially the edge vascular response (EVR) of a bioresorbable vascular scaffold (BVS) compared to a metallic everolimus-eluting stent (EES). METHODS AND RESULTS Non-serial evaluations of the Absorb BVS at one year have previously demonstrated proximal edge constrictive remodelling and distal edge changes in plaque composition with increase of the percent fibro-fatty (FF) tissue component. The 5 mm proximal and distal segments adjacent to the implanted devices were investigated serially with intravascular ultrasound (IVUS), post procedure, at six months and at two years, from the ABSORB Cohort B1 (n=45) and the SPIRIT II (n=113) trials. Twenty-two proximal and twenty-four distal edge segments were available for analysis in the ABSORB Cohort B1 trial. In the SPIRIT II trial, thirty-three proximal and forty-six distal edge segments were analysed. At the 5-mm proximal edge, the vessels treated with an Absorb BVS from post procedure to two years demonstrated a lumen loss (LL) of 6.68% (-17.33; 2.08) (p=0.027) with a trend toward plaque area increase of 7.55% (-4.68; 27.11) (p=0.06). At the 5-mm distal edge no major changes were evident at either time point. At the 5-mm proximal edge the vessels treated with a XIENCE V EES from post procedure to two years did not show any signs of LL, only plaque area decrease of 6.90% (-17.86; 4.23) (p=0.035). At the distal edge no major changes were evident with regard to either lumen area or vessel remodelling at the same time point. CONCLUSIONS The IVUS-based serial evaluation of the EVR up to two years following implantation of a bioresorbable everolimus-eluting scaffold shows a statistically significant proximal edge LL; however, this finding did not seem to have any clinical implications in the serial assessment. The upcoming imaging follow-up of the Absorb BVS at three years is anticipated to provide further information regarding the vessel wall behaviour at the edges.

Rhyming the National Spirit: Taras Shevchenko and Ilia Chavchavadze

The paper is a comparative inquiry into the roles of Ilia Chavchavadze (1837-1907) and Taras Shevchenko (1818-1861) as national poets and anti-colonial (anti-Tsarist) intellectuals within the context of their respective national traditions (Georgia and Ukraine). During the period of their activity (19th and the beginning of 20th century) both Ukraine and Georgia were under Tsarist imperial rule, albeit the two poets lived in different periods of Russian empire history. Through their major works, each called on their communities to ‘awaken’ and ‘revolt’ against oppression, rejected social apathy caused by Tsarist subjugation and raised awareness about the historical past of their nations. The non-acceptance of present and belief in an independent future was one of the dominant themes in the poetry and prose of both. Their contemporary importance is illustrated in political discourse both after Orange Revolution in Ukraine (2004), and Rose Revolution in Georgia (2003) where both poets are referred “as founding fathers of national ideology”, the history textbooks alluding to them as “symbols of anti-colonial resistance”. To this day, however, there has been surprisingly little academic writing in the West endeavoring to compare the works and activities of the two poets and their impact on national mobilization in Tsarist Ukraine and Georgia, even though their countries are often mentioned in a same breath by commentators on contemporary culture and politics. The paper attempts to fill this gap and tries to understand the relationship between literature and social mobilization in 19th century Russian Empire. By reflecting on Taras Shevchenko’s and Ilia Chavchavadze’s poetry, prose and social activism, I will try to explain how in different periods of Russian imperial history, the two poets helped to develop a modern form of political belonging among their compatriots and stimulated an anti-colonial mobilization with different political outcomes. To theorize on the role of poets and novelists in anti-colonial national movement, I will reflect on the writings of Benedict Anderson (1991), John Hutchinson (1994; 1999), Rory Finnin (2005; 2011) and problematize Miroslav Hroch’s (1996) three phase model of the development of national movements. Overall, the paper would aim to show the importance of, what John Hutchinson called, ‘cultural nationalists’ in understanding contemporary nationalist discourse in Georgian and Ukrainian societies.

Comparison of in vivo acute stent recoil between the bioresorbable everolimus-eluting coronary scaffolds (revision 1.0 and 1.1) and the metallic everolimus-eluting stent

The ABSORB cohort A trial using the bioresorbable everolimus-eluting scaffold (BVS revision 1.0, Abbott Vascular) demonstrated a slightly higher acute recoil with BVS than with metallic stents. To reinforce the mechanical strength of the scaffold, the new BVS scaffold (revision 1.1) with modified strut design was developed and tested in the ABSORB cohort B trial. This study sought to evaluate and compare the in vivo acute scaffold recoil of the BVS revision 1.0 in ABSORB cohort A and the BVS revision 1.1 in ABSORB cohort B with the historical recoil of the XIENCE V® everolimus-eluting metal stent (EES, SPIRIT I and II).