Stent implantation for relief of pulmonary artery stenosis: Immediate and short‐term results

Hijazi, Ziyad M.; Al‐Fadley, Fadel; Geggel, Robert L.; Marx, Gerald R.; Galal, Omar; Al‐Halees, Zohair; Abbag, Fuad; Fulton, David R.

doi:10.1002/(sici)1097-0304(199605)38:1<16::aid-ccd5>3.3.co;2-j

Cited by 6 publications

(12 citation statements)

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“…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]. They were also utilized to maintain patency of ductus arteriosus in pulmonary atresia and hypoplastic left heart syndrome [19][20][21], stenosed aortopulmonary collaterals [22,23] and surgically created but obstructed shunts [23,24].…”

Section: Introductionsupporting

confidence: 76%

“…They found that the peak pressure gradients decreased (51 +/-24 vs. 16 +/-13 mmHg; p<0.01) and the vessel diameter increased (5 +/-3 vs. 11 +/-4 mm; p<0.01). Subsequent studies [16,17,[48][49][50][52][53][54][55][56][57], including our own [25,50] documented similar results. The results are similar in both post-operative and native BPAS lesions [17].…”

Section: Immediate Resultsmentioning

confidence: 99%

“…Even with this technical improvement, success rate remained low, complication (ruptured pulmonary artery, hemoptysis, pulmonary edema, pulmonary artery aneurysm) rate was high, and recurrence rate was significant [43][44][45][46]. Consequently balloon expandable stents, first introduced by Palmaz et al [7], have been adopted for management of BPAS [11,16,17,[48][49][50] …”

Section: Branch Pulmonary Artery Stenosismentioning

confidence: 99%

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Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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To address elastic recoil of vessel wall and intimal dissection that can follow balloon angioplasty, stents have been designed and these appear to produce more effective relief of obstruction. Of the two types of stents, namely, balloon expandable and self expandable, balloon expandable stents are most commonly used in children. The usefulness of stents in the management of vascular obstructive lesions not amenable to balloon angioplasty is well established and has been successfully used to treat branch pulmonary artery stenosis, coarctation of the aorta, stenotic right ventricular outflow tract conduits, obstructive lesions of the systemic and pulmonary veins and others. The techniques of implantation, indications, immediate and follow-up results and complications were reviewed. The stents have also been effectively used in keeping open naturally occurring or artificially created inter-circulatory connections and as adjuncts in hybrid procedures, but these have not been discussed in this review. Future directions include investigative work on biodegradable stents and growth stents to address issues related to increase in vessel size in infants and children, use of drug eluding stents to prevent neo-intimal proliferation to avoid pulmonary vein restenosis and refinement of stent technology in hybrid procedures such as neonatal palliation of hypoplastic left heart syndrome and transcatheter completion of Fontan procedure. The feasibility, safety and effectiveness stents in the pediatric population are demonstrated, although scrutiny of results of larger experience with longer follow-up is important.

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Section: Introductionsupporting

confidence: 76%

Section: Immediate Resultsmentioning

confidence: 99%

Section: Branch Pulmonary Artery Stenosismentioning

confidence: 99%

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Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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“…In pediatric cardiac interventional procedures, the incidence of stent migration ranges between 4 -10% [1][2][3][4][5][6][7][8][9]. Although the incidence is relatively low, the consequences can be severe.…”

Section: Discussionmentioning

confidence: 99%

“…Distal displacement occurs when the tip of a catheter (particularly, a larger balloon catheter) or the tip of a sheath is readvanced over the wire into the newly implanted stent. Both proximal and distal stent displacement have also been described to occur with balloon rupture during stent implantation [1][2][3]. Stent migration, however, is more likely to occur when there is a curved course of the wire through the stent that the catheter or sheath must follow in passing into the stent.…”

Section: Introductionmentioning

confidence: 99%

A technique to prevent newly implanted stent displacement during subsequent catheter and sheath manipulation

Recto¹,

Ing²,

Grifka³

et al. 2000

Cathet. Cardiovasc. Intervent.

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We describe a novel technique to prevent the displacement or migration of a newly implanted stent as a consequence of any subsequent catheter and sheath manipulation during the same catheterization procedure. The technique involves reinflation of the dilation balloon within the stent immediately after implant followed by advancing the long delivery sheath carefully over the balloon as the balloon is slowly deflated within the stent. The technique was used successfully in 78 stents in 30 patients without stent dislodgment or migration.

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First successful implantation of a biodegradable metal stent into the left pulmonary artery of a preterm baby

Zartner¹,

Cesnjevar

Singer

et al. 2005

Cathet. Cardiovasc. Intervent.

331

162

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Stent implantation in the youngest patients with a congenital heart disease implicates limitations concerning further vessel growth, the need of staged redilation, and later surgical removal. The search to overcome these restrictions led to open stent designs, with a wide adaptability to the vessel growth and recently to the development of bioabsorbable stent materials. A preterm baby born at 26 weeks of gestation was referred to our clinic following inadvertent ligation of the left pulmonary artery. Despite efficient debanding, the left lung perfusion was absent. Implantation of a biodegradable 3 mm magnesium stent was performed in a hybrid procedure when the baby weighed 1.7 kg. Reperfusion of the left lung was established and persisted throughout the 4-month follow-up period during which the gradual degradation process of the stent completed. Additional interventions, should they become necessary, seem not to be limited. Despite the small size of the baby, the degradation process was clinically well tolerated. The mechanical and degradation characteristics of the magnesium stent proved to be adequate to secure reperfusion of the previously occluded left pulmonary artery. Bioabsorbable stents with different diameters may help develop new strategies in the therapy of vessel stenosis in pediatric patients.

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Stent implantation for relief of pulmonary artery stenosis: Immediate and short‐term results

Cited by 6 publications

References 0 publications

Transcatheter Stent Therapy in Children: An Update

Transcatheter Stent Therapy in Children: An Update

A technique to prevent newly implanted stent displacement during subsequent catheter and sheath manipulation

First successful implantation of a biodegradable metal stent into the left pulmonary artery of a preterm baby

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