Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins.

Abstract

The purpose of this investigation was to evaluate the efficacy and safety of implanting expandable intravascular stents in pulmonary arteries and systemic veins. Twenty-seven balloonexpandable grafts were placed in 13 mongrel dogs under anesthesia. A long sheath was introduced over a wire and catheter or dilator into the pulmonary artery or target vein. A collapsed stainless steel expandable mesh stent was placed over the balloon of an angioplasty catheter. The catheter with the mounted stent was advanced through the sheath. The stent expanded to the diameter of the balloon as the balloon was inflated, and remained expanded as the balloon was deflated. The stent was expanded further with a larger balloon in 11 instances. Eleven stents were placed successfully in pulmonary arteries (out of thirteen attempted), and 1 1 of 14 were installed in tributaries of the precava or postcava. Three inadvertent embolizations of the devices occurred. All three devices that embolized lodged in the pulmonary arteries and did not obstruct flow. Seven dogs were recatheterized at intervals ranging from 56 to 278 days. Twelve stents were patent and nonobstructive, and two were malpositioned, one of which was obstructed. Three animals were killed 2 months (two dogs) and 9 months (one dog) after the implantations. The stents (four in the pulmonary arteries and two in veins) were completely covered with neointima and were patent, without thrombosis. These stents hold promise for definitive dilation of congenital or postoperative vessel stenoses.

In vitroandin vivocorrosion properties of new iron–manganese alloys designed for cardiovascular applications

“…[1][2][3][4] Whereas instent restenosis complicates the postinterventional course of stented vessels in adult patients with coronary artery disease and peripheral vascular disease, growth related restenosis is a major problem after stent implantation into growing children with congenital heart defects. In the last decades, a body of evidence has challenged the "permanent" nature of various implants manufactured from stainless steel (e.g., AISI 316-L), tungsten and nitinol.…”

Transcatheter Stent Therapy in Children: An Update

“…Subsequent clinical studies showed the stents to be successful in subjects with obstructive lesions of coronary, iliac and renal arteries [6][7][8][9]. Mullins, O'Laughlin et al [10,11] introduced endovascular stents into pediatric practice. Stents were used to treat obstructions in pulmonary arteries, systemic and pulmonary veins, aorta and right ventricular outflow tract (RVOT) conduits [12][13][14][15][16][17][18].…”

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

“…637,638 Since then, their use in children has expanded considerably, now playing a major role in the management of almost all stenotic vascular lesions in children, [639][640][641] including branch pulmonary artery stenosis, 641,642 systemic venous obstructions, 643 systemic arterial stenosis such as coarctation of the aorta, [644][645][646] pulmonary vein stenosis, patent ductus arteriosus, 647 and surgical conduits or homograft prostheses. [648][649][650] Stents are also used to maintain vascular patency of the ductus arteriosus in selected conditions.…”