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Titolo:
REEXPANSION OF BALLOON-EXPANDABLE STENTS AFTER GROWTH
Autore:
MORROW WR; PALMAZ JC; TIO FO; EHLER WJ; VANDELLEN AF; MULLINS CE;
Indirizzi:
CHILDRENS HOSP MICHIGAN,DIV CARDIOL,3901 BEAUBIEN BLVD DETROIT MI 48201 WAYNE STATE UNIV,DEPT PEDIAT,DIV PEDIAT CARDIOL DETROIT MI 48202 WILFORD HALL USAF MED CTR,CLIN INVEST DIRECTORATE LACKLAND AFB TX 00000 UNIV TEXAS,HLTH SCI CTR,DEPT RADIOL SAN ANTONIO TX 78284 BAYLOR COLL MED,DEPT PEDIAT,LILLIE FRANK ABERCROMBIE SECT PEDIAT CARDIOL HOUSTON TX 77030 TEXAS CHILDRENS HOSP HOUSTON TX 00000
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 7, volume: 22, anno: 1993,
pagine: 2007 - 2013
SICI:
0735-1097(1993)22:7<2007:ROBSAG>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
PULMONARY-ARTERY STENOSIS; DILATION ANGIOPLASTY; AORTA; IMPLANTATION; COARCTATION; PLACEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
W.R. Morrow et al., "REEXPANSION OF BALLOON-EXPANDABLE STENTS AFTER GROWTH", Journal of the American College of Cardiology, 22(7), 1993, pp. 2007-2013

Abstract

Objectives. The purpose of this study was to evaluate the feasibilityof re-expansion of balloon expandable intravascular stents and to examine the gross and histologic effects of re-expansion on vascular integrity. Background. Intravascular stents have been used successfully asan adjunct to balloon dilation of congenital pulmonary artery branch stenosis and postoperative stenosis of the pulmonary arteries in children. However, use of rigid stents in children could result in development of relative stenosis at the site of stent implantation with subsequent growth of the child. Methods. Stainless steel ''iliac'' stents were placed in the thoracic aorta of 10 normal juvenile swine by a transcatheter technique. Angiography and re-expansion were performed at a mean of 11 weeks (n = 9) and again at 18 weeks (n = 5). After euthanasia, the aortic specimens were removed for gross and histologic examination. Results. Stents were successfully implanted in 10 swine. Re-expansion was successfully performed in each animal at 11 weeks and at 18 weeks. Aortic growth produced a relative constriction of the aorta of 20% +/- 10% (mean +/- SD) at the site of stent implantation at both 11 and 18 weeks. Re expansion produced a significant increase in mean stent diameter from 10.1 +/- 1 mm to 12.3 +/- 1.2 mm at 11 weeks and from11.2 +/- 0.7 to 13.5 +/- 1.1mm at 18 weeks after implantation (p < 0.001). Balloon dilation produced a relative increase in stent diameter of 21% +/- 7% at 11 weeks and 18% +/- 4% at 18 weeks. Stent re-expansion was accompanied by plastic deformation of the neointima without neointimal dissection. Where neointima was thick, there was no evidence of neointimal abrasion, but where neointima was thin, areas of localized neointimal abrasion were observed with focal fibrin and platelet adherence to the stent struts. There was no evidence of medial or adventitial hemorrhage or dissection produced by re expansion. Conclusions. Re-expansion of intravascular stents is feasible after growth in juvenile swine without significant injury to neointima, media or adventitia. The results of this study support careful and selective use of intravascular stents as an adjunct to balloon dilation of congenital stenoses in children.

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Documento generato il 31/05/20 alle ore 12:12:12