Acute stent recoil: In vivo evaluation of different stent designs

Abstract

This study sought to investigate the degree of acute recoil of four different stents by means of quantitative coronary angiography. Four hundred and six patients underwent stent implantation for single discrete coronary artery lesion: 105 received a 16 mm Paragon stent, 112 an 18 mm Multilink Duet, 97 a 16 mm NIR Primo stent, and 92 a 15 or 18 mm NIR Royal Advance. Elastic recoil was defined as the difference between mean balloon cross-sectional area (CSA) at the highest pressure and mean CSA after PTCA. The mean stent recoil was 13% +/- 10% CSA (P < 0.001), being statistically greater for the nitinol Paragon stent (21% +/- 11%), intermediate for the multicellular Multilink Duet stent (14% +/- 7%), and minimum for the NIR family (9% +/- 6% and 8% +/- 7%, respectively). The recoil was not homogeneously distributed along the stent length but was lower at the two ends (11% +/- 12% and 13% +/- 11%) and highest in the central part (15% +/- 12%)(P < 0.001). Thus, acute recoil is a significant phenomenon regardless of the mechanical properties and design of new-generation tubular stents.

Incidence, predictive factors and haemodynamic consequences of acute stent recoil following transcatheter aortic valve implantation with a balloon-expandable valve

“…These data could have implications for selecting the Taking this a step further, the present study was the first to assess the dynamic performance of a balloon-expandable valve during the implantation process, showing that some decrease in stent dimensions occurs almost systematically after balloon deflation and contributes to the failure to achieve predicted final stent dimensions. In previous coronary studies, the percentage of stent recoil was about 6% (ranging from 3 to 18%) as measured by quantitative coronary angiography 2,[16][17][18] , which is close to the degree of recoil observed in the present study. Importantly, the degree of acute relative recoil was comparable across the three levels of the valve stent frame, highlighting the fact that the elastic behaviour is homogenous in the entire prosthesis.…”

Stent expansion: a combination of delivery balloon underexpansion and acute stent recoil reduces predicted stent diameter irrespective of reference vessel size

“…Our findings are consistent with the results of previously published studies. Danzi et al 17 measured the elastic recoil of 406 tubular stents using videodensitrometry QCA. Elastic recoil was defined as the difference between the mean delivery balloon CSA at the peak pressure and the mean CSA after stent deployment.…”

Effect of Structural Remodeling (Retraction and Recoil) of the Pipeline Embolization Device on Aneurysm Occlusion Rate

“…The acute elastic recoil, resulting in a smaller lumen, ranges from 9% to 21% after deployment of a balloon-expandable or self-expanding stent. 21,22 This stent recoil is attributed to the elasticity of plaque/vessel and plastic deformation of the (nitinol or stainless) stent during deployment, independent of the size or design of stent. 22 The stent recoil leads to a suboptimal lumen size and possible restenosis; however, this recoil does subside with time (38% at 8 weeks and 12% at 6 months).…”

“…21,22 This stent recoil is attributed to the elasticity of plaque/vessel and plastic deformation of the (nitinol or stainless) stent during deployment, independent of the size or design of stent. 22 The stent recoil leads to a suboptimal lumen size and possible restenosis; however, this recoil does subside with time (38% at 8 weeks and 12% at 6 months). 23,24 The PED remodeling reduces the forces (and strain energy) required to hold all the strands together and seems to diminish with time in our limited number of cases.…”