Large-diameter graft-stent (Advanta V12) implantation in various locations: early results
Large-diameter graft-stent (Advanta V12) implantation in various locations: early results
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DOI：
10.1017/s1047951110001459
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发表时间：
2011-02-01
影响因子：
1
通讯作者：
Valeske, Klaus
中科院分区：
文献类型：
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作者：
Schranz, Dietmar;Jux, Christian;Valeske, Klaus
目的：经导管支架置入有发生心血管动脉瘤或破裂的风险。覆膜支架置入术降低了这些风险。最近上市的AdvantaV12大直径覆盖支架是预先安装的，需要9(8)-11 Fr输送系统。目的是报告一种新的聚四氟乙烯涂层支架(V12)植入治疗各种心血管阻塞的早期结果。方法：使用最小的输送系统植入直径(12、14、16 mm)的球囊内支架，使支架固定在各种阻塞(先天性主动脉缩窄5例；升主动脉修复术后梗阻2例；肺动脉5例；下腔静脉1例；闭锁上腔静脉1例；肺静脉阻塞1例；右室流出道1例)。残压梯度、支架与管壁关系或因不同原因需要再次介入或再次置入支架时，采用大直径球囊二次扩张。结果：16例5~46岁患者均行V12植入术。治疗皮损的多变性和额外干预的需要导致透视时间在7.3到48.2分钟之间的大范围(中位数17.3)。考虑到额外的操作，V12支架在所有病例中都达到了预期的效果。没有发生重大并发症。在中位时间2个月的短期随访中，所有患者都活得很好，没有支架失败的证据。结论：这些初步结果表明，覆膜AdvantaV12大直径支架在各种心血管阻塞的即刻治疗中是安全有效的。需要长期的随访。
Objectives: Transcatheter stent placement carries the risk of cardiovascular aneurysm or rupture. Covered stent implantation reduces these risks. The recently marketed Advanta V12 large-diameter-covered stent is pre-mounted and requires 9 (8)-11 Fr delivery systems. The aim was to report on the early results of the treatment of various cardiovascular obstructions by the implantation of a new polytetrafluoroethylene-covered stent (V12). Methods: Graft stents on balloons with a diameter (12, 14, 16 millimetres) sufficient to anchor the stent in various obstructions (congenital aortic coarctation, n = 5; obstruction after ascending aorta repair, n = 2; pulmonary arteries, n = 5; inferior caval vein, n = 1; atretic superior caval vein, n = 1; pulmonary vein obstruction, n = 1; and right ventricular outflow tract, n = 1) were implanted using the smallest available delivery system. Secondary dilation with larger-diameter balloons was performed when the residual pressure was gradient, the stent-vessel wall relationship or stent re-coiling due to different reasons needed a re-intervention by pure ballooning or second stent placement. Results: All 16 patients aged 5-46 years underwent V12 implantation. The variability of the treated lesions and the need for additional interventions were responsible for large ranges in fluoroscopy time between 7.3 to 48.2 minutes (median 17.3). Considering the additional procedures, the V12 stent achieved the desired result in all cases. There were no major complications. At short-term median follow-up of 2 months, all patients are alive and well with no evidence of stent failing. Conclusion: These initial results show that the covered Advanta V12 large-diameter stent is safe and effective in the immediate treatment of various cardiovascular obstructions. Long-term follow-up is required.