Stent design

Rogers C, Edelman ER. Endovascular stent design dictates experimental restenosis and thrombosis. Circulation 1995 91 2995-3001. 

Rogers C, Tseng DY, Squire JC, Edelman ER. Ballon-artery interactions during stent placement a finite element analysis approach to pressure, compliance, and stent design as contributors to vascular injury. Circ Res 1999 84 378-383. 

PCI was performed using standard techniques (6,30). All 100 patients received one or more identical close cell-stent design. The same stent design was used in order to avoid potential bias with stent selection in both groups. All patients received 325 mg/day of aspirin indefinitely and clopidogrel as a loading dose of 300 mg on the day of the procedure and 75 mg/day thereafter for one month. Statins were given to all patients indefinitely. 

Lally C, Dolan p Prendergast PJ. Cardiovascular stent design and vessel stresses a finite element analysis. J Biomech 2005 38 1574-1581. 

McClean DR, Eigler NL, Stent design implications for restenosis, Rev Cardiovasc Med 2002 3(suppl 5) SI 6-S22,... 

Rogers CDK, Drug-eluting stents role of stent design, delivery vehicle, and drug selection. Rev Cardiovasc Med 2002 3 SI 0-SI 5. 

Yoshitomi Y, Kojima S, Yano M, Sugi T, Matsumoto Y, Soatome M, Tananka K, Endo M, Kuramochi M. Does stent design affect probability of restenosis A randomized trial comparing Mutilink stents with GFX stents. Am. Heart J. 2001 142 445-451. 

Two percutaneous aortic valves have recently received CE Mark approval (CoreValve in May 2007 and Edwards-Sapien in September 2007) and several other valved stent designs are in development with first-in-man reports or in preclinical testing. Only the Edwards-Sapien valve is currently undergoing evaluation in a randomized multicenter clinical trial against surgery in the Elnited States. 

Duering, T.W. and A.R. Pelton. 2002. An overview of superelastic stent design. Mater Sci Forum 394-395 1-8. 

K. Kolandaivelu, et al.. Stent thrombogenicity early in high-risk interventional settings is driven by stent design and deployment and protected by polymer-drug coatings. Circulation 123 (2011) 1400-1409, doi 10.1161/circulationaha.ll0.003210. 

Despite the initial success of BMS to decrease the 30-50% incidence of restenosis from conventional ballooning strategies, bare metal stent technology was only successful in decreasing the probability of restenosis to 10-30% this led to further advancements in bare metal stent design to make them more biocompatible, thus reducing restenosis rates. 

FIGURE 20.5 The flexibility of a modem stent design (Cordis Corporation 7-cell BX Velocity) is demonstrated. (Cordis Corporation, Miami Lakes, Florida.)... 

The Cook Zenith AAA endovascular graft was approved for use by the FDA in May 2003 (FDA 2013). It contains three different components the main graft module, the contralateral limb module, and the ipsilateral iliac extension (Fig. 21.12). All of these are constructed with a full-thickness woven polyester fabric attached to self-expanding stainless steel Cook-Z stents with braided polyester and monofilament polypropylene sutures. The distal end of the main body has a bare stainless steel stent designed to allow suprarenal fixation without disrupting blood flow through the renal arteries (Fig. 21.13). The stent also has hooks on each strut spaced 3 mm apart that are intended to dig into the aortic wall and prevent migration (Fig. 21.13). The proximal covered stent, located just below the bare suprarenal stent. 

Greil, O., Kleinschmidt, T., Weiss, W., Wolf, O., Heider, R, Schaffner, S., Gianotti, M., Schmid, T., Liepsch, D. Berger, H. (2005) Flow velocities after carotid artery stenting impact of stent design. A fluid dynamics study in a carotid artery model with laser doppler anemometry. Cardiovascular and Interventional Radiology, 28, 66. 

S Stents Designed for Intracranial Use 220 5.4.7.9 Liquid Embolic Agents 221... 

Reported experience for the newer stent designs, such as the Flamingo and Ultraflex stents, is relatively hmited. Poyanli et al. (2001) reported good symptomatic relief and no procedure-related complications in 33 patients treated with the Flamingo stent (Poyanli et al. 2001). In a recent randomized prospective study at Guy s Hospital and St. Thomas Hospital, 37 patients were treated with Flamingo or covered Ultraflex stents. Both stents produced comparable improvements in dysphagia rehef and a similar low incidence of complications. 

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