Impact of PTFE-covered stent position and extension on TIPS patency

Cho, Joshua K.; Serna, Juan Carlos Morales; Clark, Timothy W.I.; Dagli, Mandeep; Mondschein, Jeffrey I.; Shlansky-Goldberg, Richard D.; Trerotola, Scott O.; Soulen, Michael C.; Stavropoulos, S. William; Nadolski, Gregory J.

doi:10.1007/s00261-020-02566-8

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…The majority of covered stents use polytetrafluoroethylene and have various clinical applications in peripheral arterial disease management. Covered stents offer an effective strategy for the creation of transjugular intrahepatic portosystemic shunts ( Geeroms et al, 2017 ; Cho et al, 2020 ), as well as for repair endovascular aneurysm ( O’Donnell et al, 2019 ), traumatic arterial lesions, and obstructive vascular disease of the aortoiliac and femoropopliteal sectors. Recently, the application of covered stents have expanded to seal coronary artery perforation ( Lee et al, 2016 ; Wang et al, 2017 ; Birkemeyer et al, 2021 ; Wańha et al, 2021 ) and other perforations in clinic ( Rizk et al, 2020 ).…”

Section: Current Status Of Clinical Usementioning

confidence: 99%

Applying Principles of Regenerative Medicine to Vascular Stent Development

Parthiban

Rafuse

Johnson

et al. 2022

Front. Bioeng. Biotechnol.

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Stents are a widely-used device to treat a variety of cardiovascular diseases. The purpose of this review is to explore the application of regenerative medicine principles into current and future stent designs. This review will cover regeneration-relevant approaches emerging in the current research landscape of stent technology. Regenerative stent technologies include surface engineering of stents with cell secretomes, cell-capture coatings, mimics of endothelial products, surface topography, endothelial growth factors or cell-adhesive peptides, as well as design of bioresorable materials for temporary stent support. These technologies are comparatively analyzed in terms of their regenerative effects, therapeutic effects and challenges faced; their benefits and risks are weighed up for suggestions about future stent developments. This review highlights two unique regenerative features of stent technologies: selective regeneration, which is to selectively grow endothelial cells on a stent but inhibit the proliferation and migration of smooth muscle cells, and stent-assisted regeneration of ischemic tissue injury.

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Section: Current Status Of Clinical Usementioning

confidence: 99%

Applying Principles of Regenerative Medicine to Vascular Stent Development

Parthiban

Rafuse

Johnson

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

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Cranial stent position is independently associated with the development of TIPS dysfunction

Meyer

Pérez

Chang

et al. 2022

Sci Rep

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Complications of portal hypertension can be treated with transjugular intrahepatic portosystemic shunt (TIPS) in selected patients. TIPS dysfunction is a relevant clinical problem. This study investigated the prognostic value of two-dimensional (2D) TIPS geometry for the development of TIPS dysfunction. Three hundred and seven patients undergoing TIPS procedure between 2014 and 2019 were analyzed in this monocentric retrospective study. 2D angiograms from the patients with and without TIPS dysfunction were reviewed to determine geometric characteristics including insertion and curve angles and the location of the stent. Primary outcome was the development of TIPS dysfunction. A total of 70 patients developed TIPS dysfunction and were compared to the dysfunction-free (n = 237) patients. The position of the cranial stent end in the hepatic vein and the persistence of spontaneous portosystemic shunts were significantly associated with the development of TIPS dysfunction. Among significant parameters in univariable regression analysis (portal vein-pressure after TIPS, Child–Pugh Score before TIPS, MELD before TIPS and white blood cell count before TIPS), multivariable models showed cranial stent position (p = 0.027, HR 2.300, 95% CI 1.101–4.806) and SPSS embolization (p = 0.006, HR 0.319, 95% CI 0.140–0.725) as the only predictors of TIPS dysfunction. This monocentric study demonstrates that the position of the cranial stent end is independently associated with the development of TIPS dysfunction. The distance of the cranial stent end to the IVC at the time of TIPS placement should be less than 1 cm in 2D angiography.

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Impact of PTFE-covered stent position and extension on TIPS patency

Cited by 2 publications

References 15 publications

Applying Principles of Regenerative Medicine to Vascular Stent Development

Applying Principles of Regenerative Medicine to Vascular Stent Development

Cranial stent position is independently associated with the development of TIPS dysfunction

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