Future Balloon-Expandable Stents: High or Low-Strength Materials?

Khalilimeybodi, Ali; Khoei, Amir Alishzadeh; Kashani, Babak Sharif

doi:10.1007/s13239-019-00450-1

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…Femoral artery tear, spasm, and loss of a femoral pulse have been also reported ( 20 ) and the use of a long sheath was associated with a higher risk of arterial access damage ( 18 ). Several possible adverse effects including vessel rupture, dissection, vasospasm, vessel occlusion, aneurysm formation, overdilation ( 91 – 93 ), and pseudoaneurysm are possible complications of stent insertion ( 50 ). Pulmonary hemorrhage caused by a tear of the pulmonary artery and occlusion of the distal pulmonary artery were also reported ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence

Jenab

Rezaee

Hosseini

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPatients with cyanotic complex congenital heart defects (CHDs) commonly undergo palliation with interposition of systemic-to-pulmonary shunts (SPSs). These palliative shunts are rarely found in adults with CHDs and can be complicated with progressive obstruction or total occlusion during follow-up. The best treatment option for shunt re-permeabilization is challenging and case-oriented because most patients are high risk candidates for redo surgeries. We aimed to review the current evidence on percutaneous stent implantation to treat failed SPSs.MethodsWe performed a comprehensive literature review on percutaneous stent implantation to treat failed and occluded SPSs. We also reported the case of a 33-year-old man with cyanotic CHD and a occluded central aorto-pulmonary shunt, who was successfully treated with percutaneous balloon dilatation and subsequently stent implantation at our institution.ResultWe identified and included 31 articles reporting on 150 patients and 165 stent implantations in failed SPSs. The age of patients at the time of stent implantation ranged from 6 days to 47 years. The time between the surgical shunt creation and transcatheter intervention ranged from 1 day to 17 years. Overall, 161/165 (97.5%) stent implantations were successful. The most common clinical presentation was cyanosis and decreased atrial oxygen saturations and the indication for stent implantation was shunt obstruction and stenosis.ConclusionThis review highlights the benefits of endovascular stenting to permeabilize failed SPSs in children and adults with complex CHD who are classified as poor candidates for re-surgical repair.

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Section: Discussionmentioning

confidence: 99%

Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence

Jenab

Rezaee

Hosseini

et al. 2022

Front. Cardiovasc. Med.

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“…Degree to which a deployed stent can bend along its longitudinal axis. balloon expandable stent materials possesses multi-faceted outcomes [51]. On one side, the use of materials with higher yield strength can improve the stent performance by (a) improving stent radial strength and radial stiffness thereby (b) reducing the stress on the arterial wall and the material strain.…”

Section: Conformabilitymentioning

confidence: 99%

Balloon expandable coronary stent materials: a systematic review focused on clinical success

et al. 2022

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Balloon expandable coronary stenting has revolutionized the field of interventional cardiology as a potential, minimally invasive modality for treating coronary artery disease. Even though stenting is successful compared to angioplasty (that leaves no stent in place), still there are many associated clinical complications. Bare metal stents are associated with in-stent restenosis caused mostly by neointimal hyperplasia, whereas success of drug-eluting stents comes at the expense of late-stent thrombosis and neoatherosclerosis. Even though innovative and promising, clinical trials with bioabsorbable stents reported thrombosis and a rapid pace of degradation without performing scaffolding action in several instances. It should be noted that a vast majority of these stents are based on a metallic platform which still holds the potential to mitigate major cardiovascular events and reduced economic burden to patients, alongside continuous improvement in stent technology and antiplatelet regimes. Hence, a systematic review was conducted following PRISMA guidelines to assess the clinically relevant material properties for a metallic stent material. From a materials perspective, the major causes identified for clinical failure of stents are inferior mechanical properties and blood-material interaction-related complications at the stent surface. In addition to these, the stent material should possess increased radiopacity for improved visibility and lower magnetic susceptibility values for artefact reduction. Moreover, the review provides an overview of future scope of percutaneous coronary interventional strategy. Most importantly, this review highlights the need for an interdisciplinary approach by clinicians, biomaterial scientists, and interventional cardiologists to collaborate in mitigating the impediments associated with cardiovascular stents for alleviating sufferings of millions of people worldwide.

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“…This is in line with other studies of similar constructs, which have validated under one loading condition and then extended to other conditions. [35,36]…”

Section: Experimental Validation Of Fe Scaffold Modelmentioning

confidence: 99%