Journal of the American College of Cardiology · 1993
Implantation and recovery of temporary metallic stents in canine coronary arteries.
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Eigler N L, Khorsandi M J, Forrester J S, Fishbein M C, Litvack F
Аннотация
OBJECTIVES: The purpose of this study was to test the feasibility of implanting and retrieving a heat-activated recoverable temporary stent and to determine its effect on the angiographic, gross and histologic appearance of a normal coronary artery wall.
BACKGROUND: Permanent coronary stenting is associated with a significant incidence of thrombosis, bleeding and vascular complications. These may be avoided by temporarily stenting for a period of hours to several days.
METHODS: Seventy-eight stents constructed from the shape-memory nickel-titanium alloy nitinol were deployed by balloon expansion in the coronary arteries of 28 dogs and left in place for up to 6 months. Thirty minutes to 1 week after implantation, 70 stents were recovered by flushing the coronary arteries with 3 to 5 ml of 75 degrees C lactated Ringer solution, with collapse of the stent over a recovery catheter and subsequent withdrawal.
RESULTS: All stents were successfully recovered and removed percutaneously. Mean vessel diameter after stenting was 12 +/- 6% (p < 0.05) greater than baseline diameter. Mean vessel diameter after stent removal remained enlarged (6 +/- 3%, p < 0.05). No angiographic or gross evidence of thrombosis, dissection, embolization, migration or spasm was associated with implantation or recovery. Microscopic examination revealed minor intimal injury in 40 segments (51%). Microscopic focal medial necrosis was associated with mural platelet-fibrin thrombus in 23 stented segments (29%) and media was interrupted in 7 (9%).
CONCLUSIONS: This study demonstrates the feasibility of a new method of temporary stenting that uses the thermoelastic properties of nitinol to permit reliable recovery of the stent in normal canine coronary arteries.
BACKGROUND: Permanent coronary stenting is associated with a significant incidence of thrombosis, bleeding and vascular complications. These may be avoided by temporarily stenting for a period of hours to several days.
METHODS: Seventy-eight stents constructed from the shape-memory nickel-titanium alloy nitinol were deployed by balloon expansion in the coronary arteries of 28 dogs and left in place for up to 6 months. Thirty minutes to 1 week after implantation, 70 stents were recovered by flushing the coronary arteries with 3 to 5 ml of 75 degrees C lactated Ringer solution, with collapse of the stent over a recovery catheter and subsequent withdrawal.
RESULTS: All stents were successfully recovered and removed percutaneously. Mean vessel diameter after stenting was 12 +/- 6% (p < 0.05) greater than baseline diameter. Mean vessel diameter after stent removal remained enlarged (6 +/- 3%, p < 0.05). No angiographic or gross evidence of thrombosis, dissection, embolization, migration or spasm was associated with implantation or recovery. Microscopic examination revealed minor intimal injury in 40 segments (51%). Microscopic focal medial necrosis was associated with mural platelet-fibrin thrombus in 23 stented segments (29%) and media was interrupted in 7 (9%).
CONCLUSIONS: This study demonstrates the feasibility of a new method of temporary stenting that uses the thermoelastic properties of nitinol to permit reliable recovery of the stent in normal canine coronary arteries.