Coronary stent type

More than 100 different coronary stent types are known. Many of them are still available others have been suspended but can still be found in patients that were treated in the past. Stents can be composed of different material. Most products are made from stainless steel. Cobalt-chromium is another material used frequently. Tantalum and nitinol (nickel-titanium alloy) are also being used but less frequently. Stents from biodegradable materials such as magnesium are being evaluated in phase III studies. The degree of artifacts produced by stents from different materials depends largely on the atomic number of the material. Consequently, tantalum causes the strongest artifacts, followed by steel, cobalt-... 

Takagi T Yamamuro A, Tamita K, et al, Pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus an intravascular ultrasound scanning study. Am Heart J 2003 I46 E5. 

Kastrati A, Mehilli J, Dirschinger J, Pache J, Uhn K, Schulen H, Seyfarth M, Schmitt C, Balsini R, Neumann FJ, Schomig A. Restenosis after coronary placement of various stent types. Am. J. Cardiol. 2001 87 34-39. 

Choi SH, Choi DH, Ko YK, et al. Preventive effects of rosiglitazone on restenosis after coronary stenting in patients with type 2 diabetes. ADA 63rd Scientific Sessions 2003 82-OR. 

Epidemiology 225 Coronary Artery Stent Types 226 Stent Restenosis and Thrombosis 226... 

Stents reduce the acute risk of a coronary intervention and reduce the risk of restenosis afterwards. Today, stent placement is the most frequently performed coronary revascularization treatment. CT represents a possible noninvasive method for the detection of in-stent restenosis, but in the presence of stents imaging, it is impeded by artifacts. Therefore, coronary CT angiography for the evaluation of stents is a controversial topic. Knowledge of the clinical background of the patient, stent type, location of the stent, scanner technology, scan protocols, and image reconstruction methods are crucial to define an indication for the exam and to correctly interpret scan results. 

In patients after stent placement and recurrence of symptoms, the use of CTA also may be only of limited value. Assessment of overall stent patency can rehably be performed the detailed insight into the stent though is heavily dependent on the stent type and design (Rist et al. 2006 Das et al. 2007 Hecht et al. 2008). Applying MRI in these cases may allow insight into the functional status including possible de novo stenosis and collateral coronary flow (Fig. 21.12). 

LC is a 51 -year-old female with a history of CHD (stent placement in the left anterior descending coronary artery 3 years prior) and type 2 diabetes who is referred to you for follow-up of her cholesterol. She is taking simvastatin 20 mg once daily in the evening for her cholesterol, and metformin 2000 mg once daily in the evening and piogliti-zone 15 mg once daily for diabetes. Her diabetes is well controlled. Her laboratory test results are within normal limits, except for her fasting lipid profile total cholesterol 215 mg/dL (5.57 mmol/L), triglycerides 135 mg/dL (1.53 mmol/L), HDL cholesterol 51 mg/dL (1.32 mmol/L), and LDL cholesterol 137 mg/dL (3.55 mmol/L). 

Xiang D, Huang D, Gai L and Liu H (2000) Relationship between expression of type III collagen and phenotype of vascular smooth muscle cells in neointimal of stented coronary artery. Chin Med J 113 324-327. 

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