SLOTTED AND TUBULAR BALLOON EXPANDABLE STENTS ACROSS VEIN GRAFT ANASTOMOTIC SITES

点击翻译按钮获取中文摘要

Restenosis at aortocoronary anastomotic sites is a common and difficult problem after standard percutaneous transluminal coronary angioplasty. Endovascular prosthetic devices (stents) have been a proposed solution to maintain an expanded internal scaffold which would resist radial compression and improve anastomotic site patency. The development and testing of such a device would importantly improve long term clinical results after vein graft implantation in the arterial system to bypass stenotic or occluded coronary and peripheral vessels. The current study utilizes an animal model in which reversed saphenous veins are placed end to side in femoral arteries and allowed to mature for eight weeks. Two forms of metallic stents (tubular slotted and coiled designs) were compared after balloon catheter expansion and implantation at proximal or distal anastomotic sites. Follow-up angiography and pathology analysis were performed at different time-points (3, 8, and 24 weeks). From the study we concluded that implantation of stents in vein graft at anastomotic sites results in excellent patency, rare thrombosis, occasional migration which requires careful attention to stent-vessel wall sizing factors, and rapid endothelialization which is almost always complete between 8 and 24 weeks. We believe that these studies indicate that stent implantation across the anastomotic sites may be a practical solution with favorable long term host responses.