TY - JOUR
T1 - Early clinical experience with the implantation of a novel synthetic coronary stent graft
AU - Von Birgelen, Clemens
AU - Haude, Michael
AU - Herrmann, Jörg
AU - Altmann, Christoph
AU - Klinkhart, Wolfgang
AU - Welge, Dirk
AU - Wieneke, Heinrich
AU - Baumgart, Dietrich
AU - Sack, Stefan
AU - Erbel, Raimund
PY - 1999/8
Y1 - 1999/8
N2 - Coating stents with autologous venous grafts has been suggested to prevent problems associated with conventional stenting, but the need for surgical vessel harvest hampered broad application. A novel synthetic coronary stent graft (CSG) overcomes this limitation by a synthetic membrane, fixed between two thin metallic stents. We successfully implanted 21 CSGs in 18 patients for treatment of acute coronary rupture, thrombus-containing lesions, and lesions with plaque rupture or adjacent pseudoaneurysm. Substantial residual angiographic diameter stenoses were seen in seven CSGs (25% ± 10% vs. 8% ± 6%; P < 0.01), which were implanted with relatively small balloon catheters (balloon-to-artery ratio 1.00 ± 0.09 vs. 1.24 ± 0.18; P= 0.01) and required postdilatation. Overall, the largest balloon catheter applied measured 4.0 ± 0.7 mm (balloon-to-artery ratio 1.21 ± 0.20) and the inflation pressure was 16 ± 3 atm. Final intravascular ultrasound imaging demonstrated adequate and symmetrical expansion of the CSG (≥85% ± 15% of the reference lumen). Elective implantation was associated with two small non-Q-wave myocardial infarctions, resulting from unavoidable occlusions of side branches. Thus, implantation of CSG is feasible and safe. Adequate expansion can be achieved by the use of relatively large low- compliant balloon catheters inflated with high pressure.
AB - Coating stents with autologous venous grafts has been suggested to prevent problems associated with conventional stenting, but the need for surgical vessel harvest hampered broad application. A novel synthetic coronary stent graft (CSG) overcomes this limitation by a synthetic membrane, fixed between two thin metallic stents. We successfully implanted 21 CSGs in 18 patients for treatment of acute coronary rupture, thrombus-containing lesions, and lesions with plaque rupture or adjacent pseudoaneurysm. Substantial residual angiographic diameter stenoses were seen in seven CSGs (25% ± 10% vs. 8% ± 6%; P < 0.01), which were implanted with relatively small balloon catheters (balloon-to-artery ratio 1.00 ± 0.09 vs. 1.24 ± 0.18; P= 0.01) and required postdilatation. Overall, the largest balloon catheter applied measured 4.0 ± 0.7 mm (balloon-to-artery ratio 1.21 ± 0.20) and the inflation pressure was 16 ± 3 atm. Final intravascular ultrasound imaging demonstrated adequate and symmetrical expansion of the CSG (≥85% ± 15% of the reference lumen). Elective implantation was associated with two small non-Q-wave myocardial infarctions, resulting from unavoidable occlusions of side branches. Thus, implantation of CSG is feasible and safe. Adequate expansion can be achieved by the use of relatively large low- compliant balloon catheters inflated with high pressure.
KW - Coated stent
KW - Coronary angioplasty
KW - Coronary stent
KW - Coronary stent graft
KW - Covered stent
KW - Intravascular ultrasound
UR - http://www.scopus.com/inward/record.url?scp=0032813786&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032813786&partnerID=8YFLogxK
U2 - 10.1002/(SICI)1522-726X(199908)47:4<496::AID-CCD22>3.0.CO;2-7
DO - 10.1002/(SICI)1522-726X(199908)47:4<496::AID-CCD22>3.0.CO;2-7
M3 - Article
C2 - 10470484
AN - SCOPUS:0032813786
SN - 1522-1946
VL - 47
SP - 496
EP - 503
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 4
ER -