Acute clinical and angiographic results with the new AVE Micro Coronary stent in bail-out management

Erasmus Universiteit Rotterdam, Rotterdam, South Holland, Netherlands
The American Journal of Cardiology (Impact Factor: 3.28). 08/1995; 76(3):112-6. DOI: 10.1016/S0002-9149(99)80040-X
Source: PubMed


To determine the feasibility and safety of development of this new stent, we deployed 28 AVE Micro stents in 23 native coronary artery lesions in 20 patients who developed acute or threatened closure after balloon angioplasty (BA). Ten stents were deployed in the left anterior descending artery, 10 in the circumflex, and 8 in the right coronary artery. Luminal dimensions were measured using a computer-based quantitative coronary angiographic analysis system (CAAS II). Stent deployment was successful in 27 of 28 attempts (96%). In 1 patient with a threatened closure of the left anterior descending artery associated with proximal vessel tortuosity, attempted stent deployment was unsuccessful. The clinical course of the other 19 patients in whom stent deployment was successful was free of coronary reintervention, bypass surgery, and death. A myocardial infarction was observed in 2 patients (10%), in 1 of whom the stent was implanted within 24 hours after the onset of acute myocardial infarction, and in the other acute vessel occlusion was present for 58 minutes before stent implantation. No subacute occlusion was observed. Event-free survival at 30 days after stent implantation was 85% (17 of 20 patients). Minimal luminal diameter was 0.85 +/- 0.57 mm before and 1.19 +/- 0.66 mm after BA, 2.61 +/- 0.39 mm during balloon inflation, 3.26 +/- 0.46 mm during and 2.74 +/- 0.51 mm after stenting, 3.43 +/- 0.52 mm during balloon inflation after stenting (Swiss Kiss), and 2.85 +/- 0.48 mm after Swiss Kiss.(ABSTRACT TRUNCATED AT 250 WORDS)

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    ABSTRACT: To determine the reliability of geometric (edge-detection) quantitative coronary angiographic analysis (QCA) of restenosis within a new Cordis tantalum stent, QCA and intracoronary ultrasound (ICUS) measurements were compared in both an experimental restenosis model and in the clinical follow-up of patients. In the experimental series, Plexiglas phantom vessels with concentric stenosis channels ranging from 0.75 to 3.0 mm in diameter and with a reference diameter of 3.0 mm were imaged both before and after their insertion in tantalum stents. In the clinical series, the agreement of QCA and ICUS measurements were studied in 23 patients who had undergone coronary implantation of the new tantalum stent and in 23 patients who had undergone balloon angioplasty 6 months previously. The reliability of QCA declined in the presence of the radiopaque stent (accuracy of QCA decreased from -0.07 to -0.12 mm), whereas the reliability of lumen measurements by ICUS was independent of the presence of the radiopaque stent (-0.12 and -0.13 mm). Without the stent, the average minimal luminal diameter (MLD) obtained by QCA of the 1.00 mm Plexiglas vessel was 1.00 +/- 0.01 mm, and the 3.00 mm reference vessel diameter was 2.81 +/- 0.05 mm, providing a 64 +/- 1% diameter stenosis. After introduction of the stent, the average MLD and reference vessel diameter were 0.99 +/- 0.06 and 3.36 +/- 0.17 mm, respectively, providing a diameter stenosis of 71 +/- 2%. ICUS measurements (2.77 mm) of the reference vessel diameter (3.00 mm) were unaffected by the presence of the stent.(ABSTRACT TRUNCATED AT 250 WORDS)
    Full-text · Article · Jan 1996 · The American Journal of Cardiology

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    ABSTRACT: AVE Micro Stent is a stent model, recently introduced in clinical cardiology practice in Europe and undergoing currently multicenter clinical trials in USA. Both Micro Stent I and II are formed from a continuous segment of stainless steel wire in the zigzag design, and both display eight axial struts connected by eight radiused crowns. As the basic unitary element of the Micro Stent is either 3.0 or 4.0 mm in length (I&II, respectively), these devices are premounted on AVE delivery balloons as stents of : 6.0, 8.0, 9.0, 12.0, 15.0, 18.0, 21.0, 30.0 and 39.0 mm in length. Advantages of AVE Micro Stents include limited amount of metal, excellent x-ray opacity, highly customizable length and superior trackability. The degree of recoil is similar to the J&JIS stents. Stent profile allows passage through 6 and 7F guiding catheters. High flexibility of the AVE Micro Stent expands the range of accessible vessel segments. The analysis of the use of AVE Micro Stents in 1132 patients demonstrates the low complications rate as well as an overall restenosis rate of 20.9%.
    No preview · Chapter · Jan 1996
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