Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis

Drug-eluting stents (DES) are the gold standard for percutaneous coronary interventions (PCI); however, technical and anatomical challenges need to be addressed to ensure optimal apposition and prevent late adverse events. Complex vessel anatomies, including ectatic or aneurysmatic vessels, or signi...

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Main Authors: Krzysztof Pujdak, Jan Kähler, Marc Werner
Format: Article
Language:English
Published: Radcliffe Medical Media 2020-09-01
Series:US Cardiology Review
Online Access:https://www.uscjournal.com/articles/feasibility-safety-and-clinical-performance
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author Krzysztof Pujdak
Jan Kähler
Marc Werner
author_facet Krzysztof Pujdak
Jan Kähler
Marc Werner
author_sort Krzysztof Pujdak
collection DOAJ
description Drug-eluting stents (DES) are the gold standard for percutaneous coronary interventions (PCI); however, technical and anatomical challenges need to be addressed to ensure optimal apposition and prevent late adverse events. Complex vessel anatomies, including ectatic or aneurysmatic vessels, or significant differences in diameter in left main stenosis of the coronary artery, are clinical indications in which current PCI techniques attempt to shape conventional DES to follow vessel anatomy, thus modifying the original stent scaffold and its properties. However, due to their design, balloon-expandable cobalt–chromium and cobalt–nickel DES have limitations regarding their expansion capacity, which can result in undersizing and malapposition. New stent scaffolds have recently been introduced into clinical practice to address these challenging anatomies, including a drug-eluting nitinol stent platform. The nature of the nitinol device allows conformability to the native vessel, covering complex anatomies without manual adaptation. In this article, the authors present the rationale and current data on self-apposing nitinol DES in left main stenosis, and suggest that the device may be safely and effectively used with comparable rates of adverse cardiovascular events, as seen with second-generation balloon-expandable DES.
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spelling doaj-art-5318c5ae0cd64891a9d6af3d45d0b9702024-12-14T16:02:22ZengRadcliffe Medical MediaUS Cardiology Review1758-38961758-390X2020-09-011410.15420/usc.2020.11Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main StenosisKrzysztof Pujdak0Jan Kähler1Marc Werner2Department of Cardiology, Klinikum Herford, Herford, GermanyDepartment of Cardiology, Klinikum Herford, Herford, GermanyDepartment of Cardiology, Klinikum Herford, Herford, GermanyDrug-eluting stents (DES) are the gold standard for percutaneous coronary interventions (PCI); however, technical and anatomical challenges need to be addressed to ensure optimal apposition and prevent late adverse events. Complex vessel anatomies, including ectatic or aneurysmatic vessels, or significant differences in diameter in left main stenosis of the coronary artery, are clinical indications in which current PCI techniques attempt to shape conventional DES to follow vessel anatomy, thus modifying the original stent scaffold and its properties. However, due to their design, balloon-expandable cobalt–chromium and cobalt–nickel DES have limitations regarding their expansion capacity, which can result in undersizing and malapposition. New stent scaffolds have recently been introduced into clinical practice to address these challenging anatomies, including a drug-eluting nitinol stent platform. The nature of the nitinol device allows conformability to the native vessel, covering complex anatomies without manual adaptation. In this article, the authors present the rationale and current data on self-apposing nitinol DES in left main stenosis, and suggest that the device may be safely and effectively used with comparable rates of adverse cardiovascular events, as seen with second-generation balloon-expandable DES.https://www.uscjournal.com/articles/feasibility-safety-and-clinical-performance
spellingShingle Krzysztof Pujdak
Jan Kähler
Marc Werner
Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
US Cardiology Review
title Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
title_full Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
title_fullStr Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
title_full_unstemmed Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
title_short Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis
title_sort feasibility safety and clinical performance of self apposing stents for left main stenosis
url https://www.uscjournal.com/articles/feasibility-safety-and-clinical-performance
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