Vestnik rentgenologii i radiologii · 2013
[The first clinical experience with a new type of stents -scaffolds, under optical coherence tomography guidance].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Demin V V, Chevychalov A M, Demin D V, Dolgov S A, Demin A V, Almakaev A K
Аннотация
OBJECTIVE: To analyze the first clinical experience with new types of stents, absorbable carcasses (scaffolds), under guidance of intravascular imaging techniques.
MATERIAL AND METHODS: The paper gives the authors' experience in implanting eight Absorb BVS scaffolds in three patients during one operating session. All operations were performed under intravascular imaging guidance: three patients underwent 8 examinations of four vessels, by using optical coherence tomography (OCT) and 2 did using intravascular ultrasound study (IVUSS).
RESULTS: The investigation demonstrated the possibility of implanting two devices partially applied to cover longer lesion lengths, the use of scaffolds after occlusion recanalization, and that of rather high pressure values to adapt a carcass if predilation was adequately performed. In one of the cases, control OCT could reveal timely the signs of extensive prolapse and early thrombosis, which had been unrecorded by angiography and IVUSS. To correct of the occurring problem, implantation of the second absorbable carcass into the first one was first successfully used by optimally adapting the girders and completely correcting the prolapse.
CONCLUSION: The absorbable scaffolds may potentially signify a new stage in the development of interventional cardiology. However, their use requires the careful adherence of implantation specifications and primarily the accurate estimation of vessel sizes and accordingly a device that may be needed. The application of absorbable carcasses makes higher standards for the equipment and experience of interventional laboratories that plan their use. The possibility of using intravascular imaging is one the priorities in this series.
MATERIAL AND METHODS: The paper gives the authors' experience in implanting eight Absorb BVS scaffolds in three patients during one operating session. All operations were performed under intravascular imaging guidance: three patients underwent 8 examinations of four vessels, by using optical coherence tomography (OCT) and 2 did using intravascular ultrasound study (IVUSS).
RESULTS: The investigation demonstrated the possibility of implanting two devices partially applied to cover longer lesion lengths, the use of scaffolds after occlusion recanalization, and that of rather high pressure values to adapt a carcass if predilation was adequately performed. In one of the cases, control OCT could reveal timely the signs of extensive prolapse and early thrombosis, which had been unrecorded by angiography and IVUSS. To correct of the occurring problem, implantation of the second absorbable carcass into the first one was first successfully used by optimally adapting the girders and completely correcting the prolapse.
CONCLUSION: The absorbable scaffolds may potentially signify a new stage in the development of interventional cardiology. However, their use requires the careful adherence of implantation specifications and primarily the accurate estimation of vessel sizes and accordingly a device that may be needed. The application of absorbable carcasses makes higher standards for the equipment and experience of interventional laboratories that plan their use. The possibility of using intravascular imaging is one the priorities in this series.