Risk of Dislodgement of Ultrathin Drug Eluting Stents Versus Thick Drug Eluting Stents

Rigatelli, Gianluca; Zuin, Marco; Vassilev, Dobrin; Dell’Avvocata, Fabio; Giordan, Massimo; Conte, Luca; Picariello, Claudio; Magro, Beatrice; Cardaioli, Paolo

doi:10.1016/j.amjcard.2020.03.005

Cited by 8 publications

(11 citation statements)

References 16 publications

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“…Another device factor for stent dislodgement is the stent strut thickness. Rigatelli et al reported on the relationship between stent strut thickness and dislodgement (2). They divided the stents into thick (>81 μm strut thickness) and ultrathin (≤81 μm strut thickness) strut stent groups.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…In the drug-eluting stents (DES) era, the incidence of coronary stent dislodgement has decreased to <1% compared to that in the bare metal stent era (1.5-3%) (1,2,(4)(5)(6)(7). Several coronary lesion factors are related to stent dislodgement such as heavily calcified coronary lesions, severely tortuous vessels, long diffuse lesions, ostial lesions, and previously implanted stents (2,5). Unlike characteristics associated with the coronary lesion, the relationship between stent dislodgement and device factors, such as different stent designs, stent strut thickness, and metal platforms, is not well understood.…”

mentioning

confidence: 99%

“…A recent study found that the use of thin strut stents is related to a higher incidence of stent dislodgement than thick strut stents (2). The thin strut stent improved crossability and trackability, however, it might increase the risk of stent dislodgement.…”

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confidence: 99%

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Stent dislodgement force of drug-eluting coronary stents: a bench test

Seo¹,

Yang²,

Lim³

et al. 2022

Cardiovasc Diagn Ther

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Background: Coronary stent dislodgement can cause critical complications. The dislodgement force of coronary drug-eluting stents (DES) remains unknown. This study aimed to compare the dislodgement force and pattern of contemporary DES. Methods:Five DES designs which commonly used in clinical practice were tested. The force at which the stent dislodges relative to the balloon was measured. For the shim test, peak displacement force, defined as the first peak force that occurs during stent displacement and peak dislodgement force, defined as the peak force required to completely dislodge the stent from the delivery system, were measured. Three examples of each of the stents were tested using the shim test. Results:The peak displacement force of Orsiro (3.1±0.8 N) was lower than that of Xience Sierra (5.8±0.5 N) [Firehawk 3.8±0.2 N, Resolute Onyx 4.5±1.5 N, Synergy 4.8±0.5 N (P=0.024)]. The peak dislodgement force was lowest in Orsiro (3.2±0.8 N) when compared to the other stents (Firehawk 6.6±0.6 N, Resolute Onyx 7.4±0.3 N, Synergy 11.8±0.4 N, Xience Sierra 11.1±1.6 N) (P<0.001); this remained significant in the multiple comparison analysis. During pullback of the stents, most stents buckled without removal. However, the whole Orsiro stent was completely removed from the delivery system. Conclusions:The dislodgement force of DESs differed between stent designs. The Orsiro stent was lower than that of other DES; additionally, it easily removed the whole stent from the delivery system. During the coronary intervention, operators should consider stent design and be cautious when pulling DES back in lesions with calcifications or a previously implanted stent, which are at high risk for stent dislodgement.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Stent dislodgement force of drug-eluting coronary stents: a bench test

Seo¹,

Yang²,

Lim³

et al. 2022

Cardiovasc Diagn Ther

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“…Notably, dislodgement typically occurs during the stent delivery step, leading to unfavorable clinical outcomes such as death and bleeding complications that require transfusion. [ 10 ] Stent dislodgement is also common in metal stents. While the geometry and material of the stent may contribute to dislodging, the successful delivery of the stent fundamentally relies on the retention performance of the delivery system.…”

Section: Introductionmentioning

confidence: 99%

Formation of Balloon with Porous Structures in NaCl Vapor Assisted by Amphiphilic Polymer for Stent Delivery System

Lee,

Park,

Kim

et al. 2023

Adv Materials Technologies

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Recently, bioabsorbable vascular stents (BVSs) are actively studied owing to their ability to dissolve within the human body. However, despite their advantages, BVSs often dislodge from the expandable balloon‐based delivery system when transported to the lesion site. In this study, a novel methodology aiming at increasing the retention force between the stent and the delivery system is presented. The breath‐figure method is adopted to form a porous structure and enhance adhesion. Additionally, numerical and experimental methods are used to evaluate the effect of surface tension between two immiscible fluids (polymeric solutions and droplets). To control the interfacial tension between the solution and droplets, an amphiphilic polymer and NaCl‐added vapor are used. By selecting the appropriate parameters, a sponge‐like structure is prepared on the stent delivery system. To verify its applicability, the two types of structures presented in this study are experimentally compared. These findings provide valuable guidelines for understanding the mechanism of breath‐figure patterns. Thus, the innovative methodology developed in this study demonstrates simplicity and scalability for large‐area production, making it potentially applicable to industrial technologies and offering new insights into biomedical engineering.

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The hyperdeliverability of the latest evolution of drug-eluting stents should not cause any steps to be omitted during percutaneous coronary intervention

Barone-Rochette

2021

Archives of Cardiovascular Diseases

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Risk of Dislodgement of Ultrathin Drug Eluting Stents Versus Thick Drug Eluting Stents

Cited by 8 publications

References 16 publications

Stent dislodgement force of drug-eluting coronary stents: a bench test

Stent dislodgement force of drug-eluting coronary stents: a bench test

Formation of Balloon with Porous Structures in NaCl Vapor Assisted by Amphiphilic Polymer for Stent Delivery System

The hyperdeliverability of the latest evolution of drug-eluting stents should not cause any steps to be omitted during percutaneous coronary intervention

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