Request for Funding
Medical Student Research Fellowship for Summer 2011

All descriptions must contain enough detail to permit an assessment of the problem that is to be addressed and the methodologies that are to be employed. Please be careful to outline the role that the student will play in the project that is described. Please ensure that all relevant approval numbers (IRB, IACUC) are provided.

Mentor:                       Emmanouil S. Brilakis, MD, PhD   
Department:               Cardiology
Room number:           VA 5B-670
Mail Code:                 111A
Phone number:          214-857-1547
E-mail:                        esbrilakis@yahoo.com – Emmanouil.brilakis@utsouthwestern.edu

Project #1 title:        Prospective Evaluation of the Xience V Everolimus-Eluting Stent In Saphenous Vein Graft Atherosclerosis: The Xience V-SVG Angiographic Study

Human subjects IRB approved project number (where applicable):       09-016

Project Type  patient-based research

Brief Description of Project:

Implantation of bare metal coronary stents (BMS) is currently the preferred percutaneous treatment for aortocoronary saphenous vein bypass graft (SVG) lesions, but is associated with high risk for in-stent restenosis. Although drug-eluting stents (DES) appear promising, there are limited and conflicting data on their efficacy and safety in SVGs. Our group recently completed and reported the angiographic follow-up of the SOS (Stenting Of Saphenous vein grafts) trial that compared a paclitaxel-eluting stent with a similar BMS. There is currently no data on the use of the second generation DES in these challenging lesions. We propose a pilot study to examine the effects of the Xience V everolimus-eluting stent in SVG lesions.

The specific aim of this proposal is to examine the 12-month incidence of binary angiographic in-stent restenosis (defined as a stenosis of >50% of the minimum lumen diameter of the target segment) after implantation of the Xience V stent in SVG lesions.

The Xience V stent will be implanted in 40 consecutive patients who need stenting of a SVG lesion. Patients will undergo repeat follow-up angiography and intravascular ultrasonography at 12 months and will be followed clinically for 12 months to determine:

    (1) the incidence of binary angiographic in-stent restenosis, as assessed by 12 month follow-up quantitative coronary angiography (primary study endpoint), and
    (2) intra-stent intimal hyperplasia volume accumulation at 12 months, as measured by intravascular ultrasonography, and (b) 12-month incidence of ischemia-driven target vessel revascularization, stent thrombosis, and target vessel failure (composite of cardiac death, myocardial infarction, and target vessel revascularization) (secondary study endpoints).

 

Project #2 title:        Correlation of Intravascular Ultrasonography Virtual Histology with Patients’ Baseline Clinical Characteristics and Clinical Outcome

 

Human subjects IRB approved project number (where applicable):       09-021

Animal subjects IRB approved project number (where applicable):       NA

Project Type patient-based research

Brief Description of Project

This study will retrospectively evaluate the correlation between the post-processed Virtual Histology (VH) of Intravascular Ultrasonography (IVUS) and patient’s baseline clinical characteristics and subsequent clinical outcomes. This study is a retrospective, multi-center, non-randomized analysis of correlation between IVUS-VH data and patient clinical characteristics and subsequent clinical events at the follow-up.
Primary end point of the study is time from index IVUS procedure to clinical follow-up events such as myocardial infarction, revascularization, and death. Secondary endpoint is correlation of IVUS-VH findings with baseline demographics.

 

Previous Research Activities or Publications with Medical Students:

  1. Jeroudi O, Abdel-Karim AR, Michael TT, Lichtenwalter C, de Lemos JA, Obel O, Addo TA, Roesle M, Haagen D, Rangan BV, Raghunathan D, DaSilva M, Saeed B, Bissett JK, Sachdeva R, Voudris VV, Karyofillis P, Kar B, Rossen J, Fasseas P, Berger PB, Banerjee S, Brilakis ES. Paclitaxel-Eluting Stents Reduce Neointimal Hyperplasia Compared to Bare Metal Stent in Saphenous Vein Grafts: Results from the SOS (Stenting of Saphenous Vein Grafts) Trial EuroIntervention. 2011:in press.
  1. Raghunathan D, Abdel-karim AR, Papayannis AC, daSilva M, Jeroudi O, Rangan BV, Banerjee S, Brilakis ES. Relation between the Presence and Extent of Coronary Lipid Core Plaques Detected by Near-Infrared Spectroscopy Following Percutaneous Coronary Intervention. Am J Cardiol 2011;in press
  1. Garcia BA, Wood F, Cipher D, Banerjee S, Brilakis ES. Reproducibility of Near-Infrared Spectroscopy for the Detection of Lipid Core Coronary Plaques and Observed Changes After Coronary Stent Implantation. Catheter Cardiovasc Interv 2010;76:359–365
  2. Wood FO, Badhey N, Garcia B, Abdel-karim AR, Maini B, Banerjee S, Brilakis ES. Analysis of Saphenous Vein Graft Lesion Composition Using Near-infrared spectroscopy and Intravascular Ultrasonography with Virtual Histology. Atherosclerosis 2010;212:528-533
  3. Boatman D, Saeed B, Varghese I, Peters CT,  Daye J, Haider A, Roesle M, Banerjee S, Brilakis ES. Prior coronary artery bypass graft surgery patients undergoing diagnostic coronary angiography have multiple uncontrolled coronary artery disease risk factors and high risk for cardiovascular events. Heart Vessels 2009;24:241-246
  4. Daye J, Boatman D, Peters C, Varghese I, Haider A, Roesle M, Jessen ME, DiMaio JM, Banerjee S, Brilakis ES. Perioperative Risk of Patients Undergoing Noncardiac Surgery After Coronary Artery Bypass Surgery. J Investig Med 2008;56:878-881
  5. Iturbe JM, Banerjee S, Brilakis ES. Exertional dyspnea due to spontaneous coronary artery dissection in a 55-year-man.Heart 2007;93:1212