Intravascular Stents to Prevent Occlusion and Re-Stenosis after Transluminal Angioplasty

Abstract

Occlusion and restenosis are the most common reasons that transluminal balloon angioplasty may fail to provide long-term benefit. An intravascular mechanical support was therefore developed with the aim of preventing restenosis and sudden closure of diseased arteries after angioplasty. The endoprosthesis consists of a self-expandable stainless-steel mesh that can be implanted nonsurgically in the coronary or peripheral arteries. Experiments in animals showed complete intimal coverage within weeks and no late thrombosis during a follow-up period of up to one year. We performed 10 implantations in 6 patients for iliac or femoral arterial disease; 24 coronary-artery stents were implanted in 19 patients who presented with coronary-artery restenoses (n = 17) or abrupt closure (n = 4) after transluminal angioplasty or deterioration of coronary-bypass grafts (n = 3). We observed three complications in the group with coronary disease. One thrombotic occlusion of a stent resulted in asymptomatic closure, a second acute thrombosis was managed successfully with thrombolysis, and one patient died after bypass surgery for a suspected but unfound occlusion. Follow-up in the patients has continued for nine months without evidence of any further restenoses within the stented segments. Our preliminary experience suggests that this vascular endoprosthesis may offer a useful way to prevent occlusion and restenosis after transluminal angioplasty. Long-term follow-up will be required to validate the early success of this procedure.

Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause

“…From the introduction of endovascular stents at the middle/end of the 1980 s to the approval of the Food and Drug Administration (FDA) of balloon-expandable stents in 1994 and the introduction of drug-eluting stents (DES) 12 years ago, endovascular stents have become an important option in the medical treatment spectrum over the last 30 years [1]. They are most commonly used in coronary artery interventions [2].…”

Urolume urethral wallstent in the treatment of detrusor sphincter dyssynergia

“…Urethral catheterization was also avoided postoperatively. All patients were followed with KUB, renal ultrasound, retrograde urethrogram, cystoscopy, and videouro- dynamics at 3,6, and 12 months postopera tively. Videourodynamics were performed in a similar fashion pre-and postopera tively.…”

Drug eluting stents: To evolve or dissolve?

“…The quandary of restenosis with PTCA was addressed by the next innovation in the form of a metallic stent implant in the coronary in 1986 by Sigwart et al 2 The deployed stent promptly sealed disrupted plaques and splinted angioplasty induced dissection with resultant plaque stabilisation. The stanchion provided by the metal platform resulted in acute gain in vessel calibre and offset the vessel recoil and constrictive remodelling.…”