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John Charonko - One of the best experts on this subject based on the ideXlab platform.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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in vitro time resolved piv comparison of the effect of Stent Design on wall shear stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V® (Abbott Vascular), TAXUS® Liberte® (Boston Scientific), Endeavor® (Medtronic), and Cypher® (J&J Cordis)] and a bare-metal Stent [VISION® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm2 (Cypher®) to 8.52 dynes/cm2 (XIENCE V®) in resting conditions, and from 3.72 dynes/cm2 (Cypher®) to 14.66 dynes/cm2 (VISION®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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A Time Resolved DPIV In-Vitro Evaluation of Coronary Stents in Realistic Conditions: Part II — Effect of Stent Design
ASME 2008 Summer Bioengineering Conference Parts A and B, 2008Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:Cardiovascular disease has historically been the leading cause of death in the US [1], and accounts for approximately one third of all deaths worldwide [2]. Coronary artery disease in particular accounts for over fifty percent of these deaths and in 2004 was the single largest killer, affecting approximately 15 million people every year [1]. Coronary Stenting was approved in 1994 by the FDA, and has become one of the leading treatments for the disease. However, problems persist in both bare metal and drug-eluting Stents (DESs) with restenosis and thrombosis. It is well accepted that disruptions in arterial wall shear stress (WSS), especially low WSS, are linked to alterations in the endothelial cell layer and ultimately disease [3], although the exact mechanisms are still uncertain. Additionally, studies have shown that Stent Design is closely linked to clinical outcomes [4].Copyright © 2008 by ASME
Pavlos Vlachos - One of the best experts on this subject based on the ideXlab platform.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
Satyaprakash Karri - One of the best experts on this subject based on the ideXlab platform.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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Effect of Stent Design Parameters on Coronary Artery Flow
ASME 2009 Summer Bioengineering Conference Parts A and B, 2009Co-Authors: Satyaprakash Karri, Stephen Peter, Pavlos P. VlachosAbstract:The most widely accepted modality for treating diseased arteries is the implantation of endovascular Stents. Stents are metallic wireframe devices used to reopen clogged arteries. Despite their widespread use, problems persist post-implantation of these devices beginning with sub-acute thrombus formation followed by inflammation, proliferation and remodeling [1]. The specific Stent Design and its Design parameters profoundly impact the hemodynamic environment of the Stent [2], in turn affecting thrombus accumulation between struts and thus restenosis [3]. Prior research examining the hemodynamic effects of Stents has been performed in simplified geometries [4] however the effects of Stent Design parameters such as strut thickness and crown radius of curvature or analysis in realistic geometries is generally lacking. A more thorough understanding of the effect of a Stent’s geometric parameters on the arterial flow will provide insight into their long-term performance and will lead to better Design.Copyright © 2009 by ASME
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in vitro time resolved piv comparison of the effect of Stent Design on wall shear stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V® (Abbott Vascular), TAXUS® Liberte® (Boston Scientific), Endeavor® (Medtronic), and Cypher® (J&J Cordis)] and a bare-metal Stent [VISION® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm2 (Cypher®) to 8.52 dynes/cm2 (XIENCE V®) in resting conditions, and from 3.72 dynes/cm2 (Cypher®) to 14.66 dynes/cm2 (VISION®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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A Time Resolved DPIV In-Vitro Evaluation of Coronary Stents in Realistic Conditions: Part II — Effect of Stent Design
ASME 2008 Summer Bioengineering Conference Parts A and B, 2008Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:Cardiovascular disease has historically been the leading cause of death in the US [1], and accounts for approximately one third of all deaths worldwide [2]. Coronary artery disease in particular accounts for over fifty percent of these deaths and in 2004 was the single largest killer, affecting approximately 15 million people every year [1]. Coronary Stenting was approved in 1994 by the FDA, and has become one of the leading treatments for the disease. However, problems persist in both bare metal and drug-eluting Stents (DESs) with restenosis and thrombosis. It is well accepted that disruptions in arterial wall shear stress (WSS), especially low WSS, are linked to alterations in the endothelial cell layer and ultimately disease [3], although the exact mechanisms are still uncertain. Additionally, studies have shown that Stent Design is closely linked to clinical outcomes [4].Copyright © 2008 by ASME
Jaime Schmieg - One of the best experts on this subject based on the ideXlab platform.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh Prabhu, Pavlos VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V^® (Abbott Vascular), TAXUS^® Liberté^® (Boston Scientific), Endeavor^® (Medtronic), and Cypher^® (J&J Cordis)] and a bare-metal Stent [VISION^® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm^2 (Cypher^®) to 8.52 dynes/cm^2 (XIENCE V^®) in resting conditions, and from 3.72 dynes/cm^2 (Cypher^®) to 14.66 dynes/cm^2 (VISION^®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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in vitro time resolved piv comparison of the effect of Stent Design on wall shear stress
Annals of Biomedical Engineering, 2009Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:The effect of Stent Design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting Stents [XIENCE V® (Abbott Vascular), TAXUS® Liberte® (Boston Scientific), Endeavor® (Medtronic), and Cypher® (J&J Cordis)] and a bare-metal Stent [VISION® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that Design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm2 (Cypher®) to 8.52 dynes/cm2 (XIENCE V®) in resting conditions, and from 3.72 dynes/cm2 (Cypher®) to 14.66 dynes/cm2 (VISION®) for the exercise state. Within the Stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of Stent Design on the WSS experienced by endothelial cells in coronary arteries.
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A Time Resolved DPIV In-Vitro Evaluation of Coronary Stents in Realistic Conditions: Part II — Effect of Stent Design
ASME 2008 Summer Bioengineering Conference Parts A and B, 2008Co-Authors: John Charonko, Satyaprakash Karri, Jaime Schmieg, Santosh V Prabhu, Pavlos P. VlachosAbstract:Cardiovascular disease has historically been the leading cause of death in the US [1], and accounts for approximately one third of all deaths worldwide [2]. Coronary artery disease in particular accounts for over fifty percent of these deaths and in 2004 was the single largest killer, affecting approximately 15 million people every year [1]. Coronary Stenting was approved in 1994 by the FDA, and has become one of the leading treatments for the disease. However, problems persist in both bare metal and drug-eluting Stents (DESs) with restenosis and thrombosis. It is well accepted that disruptions in arterial wall shear stress (WSS), especially low WSS, are linked to alterations in the endothelial cell layer and ultimately disease [3], although the exact mechanisms are still uncertain. Additionally, studies have shown that Stent Design is closely linked to clinical outcomes [4].Copyright © 2008 by ASME
C Macaya - One of the best experts on this subject based on the ideXlab platform.
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Long-term angiographic results of Stenting in chronic total occlusions: influence of Stent Design and vessel size.
American heart journal, 1999Co-Authors: J Escaned, J Cortes, M A Alcocer, J Goicolea, F Alfonso, A Fernandez-ortiz, R Hernandez, C Bañuelos, C MacayaAbstract:Although coronary Stenting has decreased the high restenosis rate associated with percutaneous transluminal coronary angioplasty of chronic total occlusions (CTOs), the results are still less satisfactory than those found in nonoccluded lesions, at least as reported with the Palmaz-Schatz Stent. The present work compares the restenosis rate of other Stent Designs with that of the Palmaz-Schatz Stent. We studied the long-term angiographic outcome of 120 CTOs successfully recanalized with balloon-expandable Stents and without concomitant debulking techniques. Angiographic follow-up and full quantitative coronary angiography analysis was prospectively performed in all patients. Three different Stent Designs were compared: Palmaz-Schatz (n = 47), coil (n = 24), and multicellular (n = 49). Particular attention was paid to their performance in vessels of 3 mm or less and greater than 3 mm in diameter. Restenosis was defined as a 50% or greater diameter stenosis at follow-up. Multicellular Stents were implanted more frequently in the left anterior descending artery and in patients with multivessel disease. No other significant differences in clinical or angiographic baseline characteristics, including vessel size, were noted between groups. At follow-up, multicellular Stents presented a lower restenosis rate (22% vs 36% and 58% in the Palmaz-Schatz and coil Stent groups, respectively; P =.01 ) and larger minimal luminal diameters (1.92 +/- 0.85 mm vs 1.73 +/- 0.98 and 1.38 +/- 0.83 mm in the Palmaz-Schatz and coil Stent groups, respectively; P = 0.0). The superiority of the multicellular Stent Design resulted from a lower restenosis rate in vessels of 3.0 mm or less in diameter (20% vs 47% and 79% in the Palmaz-Schatz and coil Stent groups, respectively; P =.006). These results suggest that the restenosis rate after Stent recanalization of CTOs is influenced by both Stent Design and vessel size and may indicate a superiority of multicellular over Palmaz-Schatz and coil Stent Designs for this purpose.
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Long-term angiographic results of Stenting in chronic total occlusions: influence of Stent Design and vessel size.
American Heart Journal, 1999Co-Authors: J Escaned, J Cortes, M A Alcocer, J Goicolea, F Alfonso, A Fernandez-ortiz, R Hernandez, C Bañuelos, C MacayaAbstract:Abstract Background Although coronary Stenting has decreased the high restenosis rate associated with percutaneous transluminal coronary angioplasty of chronic total occlusions (CTOs), the results are still less satisfactory than those found in nonoccluded lesions, at least as reported with the Palmaz-Schatz Stent. The present work compares the restenosis rate of other Stent Designs with that of the Palmaz-Schatz Stent. Methods We studied the long-term angiographic outcome of 120 CTOs successfully recanalized with balloon-expandable Stents and without concomitant debulking techniques. Angiographic follow-up and full quantitative coronary angiography analysis was prospectively performed in all patients. Three different Stent Designs were compared: Palmaz-Schatz (n = 47), coil (n = 24), and multicellular (n = 49). Particular attention was paid to their performance in vessels of 3 mm or less and greater than 3 mm in diameter. Restenosis was defined as a 50% or greater diameter stenosis at follow-up. Results Multicellular Stents were implanted more frequently in the left anterior descending artery and in patients with multivessel disease. No other significant differences in clinical or angiographic baseline characteristics, including vessel size, were noted between groups. At follow-up, multicellular Stents presented a lower restenosis rate (22% vs 36% and 58% in the Palmaz-Schatz and coil Stent groups, respectively; P = .01 ) and larger minimal luminal diameters (1.92 ± 0.85 mm vs 1.73 ± 0.98 and 1.38 ± 0.83 mm in the Palmaz-Schatz and coil Stent groups, respectively; P = 0.0). The superiority of the multicellular Stent Design resulted from a lower restenosis rate in vessels of 3.0 mm or less in diameter (20% vs 47% and 79% in the Palmaz-Schatz and coil Stent groups, respectively; P = .006). Conclusions These results suggest that the restenosis rate after Stent recanalization of CTOs is influenced by both Stent Design and vessel size and may indicate a superiority of multicellular over Palmaz-Schatz and coil Stent Designs for this purpose. (Am Heart J 1999;138:675-80.)