Stretched to the Limit: Comparing Polytetrafluoroethylene-Covered Endovascular Stents Through Serial Dilations.

Autor:	Mejia E; Division of Pediatric Cardiology, University Hospitals, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio., Kish EC; Division of Pediatric Cardiology, University Hospitals, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio., Bocks ML; Division of Pediatric Cardiology, University Hospitals, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio., Lozier JS; Division of Pediatric Cardiology, University Hospitals, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	Journal of the Society for Cardiovascular Angiography & Interventions [J Soc Cardiovasc Angiogr Interv] 2022 Apr 11; Vol. 1 (2), pp. 100035. Date of Electronic Publication: 2022 Apr 11 (Print Publication: 2022).
DOI:	10.1016/j.jscai.2022.100035
Abstrakt:	Background: Covered stents are used during congenital cardiac interventions to treat stenotic or injured vessels or to exclude unwanted vascular connections. The ability to postdilate a stented vessel to keep pace with somatic growth is critical in children. In this study, we aimed to compare in vitro performance of 2 brands of covered stents during serial dilations to demonstrate the threshold for stent fracture and polytetrafluoroethylene tear and define recoil and foreshortening characteristics. Methods: iCast and VBX stents of various sizes were measured before and after expansion and through serial dilations. Dilations were performed at 2-mm increments until stent fracture, polytetrafluoroethylene tear, and "napkin-ring" formation, to a maximum of 22-mm diameter. Results: The 5- and 6-mm VBX stents fractured during dilation with 10-mm balloon; the 7-mm VBX stents fractured on the 14-mm balloon; and the largest VBX stents fractured on the 20- or 22-mm balloons. iCast stents experienced partial fracture during dilation with the 14- or 16-mm balloons and complete fracture past dilation with 16-mm balloons. VBX stents recoiled less at nominal diameters. Both stents had similar foreshortening at nominal diameters, although VBX stents had more significant foreshortening with postdilation. Conclusions: All iCast stents experienced partial fracture with dilation between 14- and 16-mm diameter and had unpredictable fracturing patterns. VBX stents showed a more predictable fracture pattern and had less recoil with nominal inflation but more foreshortening with postdilation. These findings may add clinical benefit and empower physicians to make optimal decisions regarding future planning of interventions in children with congenital heart disease. Competing Interests: The VBX stents were provided by the W. L. Gore & Associates, Inc. through a research agreement. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© 2022 The Authors.)
Databáze:	MEDLINE
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