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Are self-expanding stents superior to balloon-expanded in dilating aortas? An experimental study in pigs

Mangell, Peter LU ; Malina, Martin LU ; Vogt, K; Lindh, Mats LU ; Schroeder, T; Risberg, B; Brunkwall, J and Länne, T (1996) In European Journal of Vascular and Endovascular Surgery 12(3). p.287-294
Abstract
OBJECTIVE: To study the stent/vessel interaction and distensibility following the natural increase in vascular diameter using self-expanding and balloon-expanded stents. DESIGN: Open experimental study. SETTING: Animal laboratory, university hospital. MATERIALS AND METHODS: Eight Palmaz (P) and eight Gianturco (G) stents were transluminally placed in the infrarenal aortas of 16 pigs. Pulsatile diameter changes above, at and below the stents were non-invasively monitored with an ultrasound phase-locked echo-tracking system before and immediately after stenting and at 4 and 18 weeks. Blood pressure was registered intra-arterially and stiffness (beta) was calculated. Intravascular ultrasound (IVUS) was performed at 18 weeks. RESULTS: Median... (More)
OBJECTIVE: To study the stent/vessel interaction and distensibility following the natural increase in vascular diameter using self-expanding and balloon-expanded stents. DESIGN: Open experimental study. SETTING: Animal laboratory, university hospital. MATERIALS AND METHODS: Eight Palmaz (P) and eight Gianturco (G) stents were transluminally placed in the infrarenal aortas of 16 pigs. Pulsatile diameter changes above, at and below the stents were non-invasively monitored with an ultrasound phase-locked echo-tracking system before and immediately after stenting and at 4 and 18 weeks. Blood pressure was registered intra-arterially and stiffness (beta) was calculated. Intravascular ultrasound (IVUS) was performed at 18 weeks. RESULTS: Median weight increased from 20 kg (19-26) to 93 kg (62-130). Diameter of the aorta increased 60%. In group P no pulsatile diameter change could be measured at the stent (beta = infinity). In group G stenting increased stiffness from beta 20.7 (9.2) to 43.2 (8.0) (p < 0.05). After 18 weeks stiffness returned to beta 20.1 (12.4). Expanded, median diameter of the P stents was 7.4 (0.8) mm, not increasing after 18 weeks. Initial diameter of the G stents was 7.8 (1.0) mm, increasing 56% to 12.2 (2.3) mm (p < 0.05). IVUS revealed the G stents to be well attached to the vascular wall, but five P stents were detached within half of the circumference. CONCLUSION: Self-expanding stents follow the pulsatile diameter change of the vessel wall, not adversely affecting distensibility after 18 weeks. They show good attachment despite 56% dilation. In contrast, the balloon-expanded stents do not show pulsatile movement and may detach during vessel diameter increase. This may be of importance when choosing stents for endovascular treatment of abdominal aortic aneurysms. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endovascular stents, Aorta, Ultrasound, Diameter, Distensibility
in
European Journal of Vascular and Endovascular Surgery
volume
12
issue
3
pages
287 - 294
publisher
Elsevier
external identifiers
  • pmid:8896470
  • scopus:0029957458
ISSN
1532-2165
DOI
10.1016/S1078-5884(96)80246-2
language
English
LU publication?
yes
id
700619f9-f191-4cbc-a825-e4e3e269460f (old id 1109988)
date added to LUP
2008-07-25 16:57:53
date last changed
2017-01-01 07:18:57
@article{700619f9-f191-4cbc-a825-e4e3e269460f,
  abstract     = {OBJECTIVE: To study the stent/vessel interaction and distensibility following the natural increase in vascular diameter using self-expanding and balloon-expanded stents. DESIGN: Open experimental study. SETTING: Animal laboratory, university hospital. MATERIALS AND METHODS: Eight Palmaz (P) and eight Gianturco (G) stents were transluminally placed in the infrarenal aortas of 16 pigs. Pulsatile diameter changes above, at and below the stents were non-invasively monitored with an ultrasound phase-locked echo-tracking system before and immediately after stenting and at 4 and 18 weeks. Blood pressure was registered intra-arterially and stiffness (beta) was calculated. Intravascular ultrasound (IVUS) was performed at 18 weeks. RESULTS: Median weight increased from 20 kg (19-26) to 93 kg (62-130). Diameter of the aorta increased 60%. In group P no pulsatile diameter change could be measured at the stent (beta = infinity). In group G stenting increased stiffness from beta 20.7 (9.2) to 43.2 (8.0) (p &lt; 0.05). After 18 weeks stiffness returned to beta 20.1 (12.4). Expanded, median diameter of the P stents was 7.4 (0.8) mm, not increasing after 18 weeks. Initial diameter of the G stents was 7.8 (1.0) mm, increasing 56% to 12.2 (2.3) mm (p &lt; 0.05). IVUS revealed the G stents to be well attached to the vascular wall, but five P stents were detached within half of the circumference. CONCLUSION: Self-expanding stents follow the pulsatile diameter change of the vessel wall, not adversely affecting distensibility after 18 weeks. They show good attachment despite 56% dilation. In contrast, the balloon-expanded stents do not show pulsatile movement and may detach during vessel diameter increase. This may be of importance when choosing stents for endovascular treatment of abdominal aortic aneurysms.},
  author       = {Mangell, Peter and Malina, Martin and Vogt, K and Lindh, Mats and Schroeder, T and Risberg, B and Brunkwall, J and Länne, T},
  issn         = {1532-2165},
  keyword      = {Endovascular stents,Aorta,Ultrasound,Diameter,Distensibility},
  language     = {eng},
  number       = {3},
  pages        = {287--294},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Are self-expanding stents superior to balloon-expanded in dilating aortas? An experimental study in pigs},
  url          = {http://dx.doi.org/10.1016/S1078-5884(96)80246-2},
  volume       = {12},
  year         = {1996},
}