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- Title:
Proof of Concept: A New Solution for Low-Profile Transcatheter Implantation of Optimus-L Stents in Small Children.
- Document type:
- Journal Article
- Author(s):
- Haddad, Raymond N; Eicken, Andreas; Adel Hassan, Ahmed; Gendera, Katarzyna; Kasem, Mohamed; Georgiev, Stanimir
- Abstract:
- BACKGROUND: There is no stent designed or approved for use in infants. We sought to obtain in vitro and in vivo data on a new concept conceived to implant Optimus-L stents at infant vessel diameters and offer a potential long term stent solution. METHODS: Nineteen Optimus-L stents were mounted on 8 types of angioplasty balloons with diameters 6, 8, and 10 mm with the use of an injection-moulded hand crimper. We evaluated balloon-stent unit (BSU) stability before insertion and advancement through short Terumo introducers with incremental French size and possibility of side-arm contrast injections. Three types of long sheaths were tested. Stents were inflated to balloon nominal diameters and re-expanded to 18 and 23 mm. Stent recoil, foreshortening, and fracture were evaluated. In vivo implantations were performed afterward. RESULTS: In vitro: Medtronic Evercross balloons and modified Terumo Destination sheaths were the best combination: BSUs were inserted in 6 F sheaths with possible injections (for 6 and 8 mm balloons), and 7 F sheaths without injections (for the 10 mm balloon). Retrieving BSUs inside the sheath required 1 additional F-size. Boston Scientific Sterling and Balton Lovix balloons, as well as APT Braidin L guiding sheaths showed unsatisfactory performance. Dilation up to 23 mm was possible, and stent shortening was < 24% at 18 mm and < 37% at 23 mm. Recoil was limited, and no stent fractured. In vivo: Optimus-L stents were used to treat 2 infants with aortic coarctation and 2 children with pulmonary artery stenosis with the use of 8 mm balloons and low-profile access. CONCLUSIONS: Optimus-L stents can be implanted safely in small patients with a low-profile approach. These stents have the potential to achieve adult size while maintaining structural integrity.
- Journal title abbreviation:
- Can J Cardiol
- Year:
- 2024
- Journal volume:
- 40
- Journal issue:
- 1
- Pages contribution:
- 77-86
- Fulltext / DOI:
- doi:10.1016/j.cjca.2023.09.015
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/37726075
- Print-ISSN:
- 0828-282X
- TUM Institution:
- Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)
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