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Hazard in ductal stenting: Helicoid open cell stents
Author(s) -
Kitzmüller Erwin,
Luckner Doris,
MichelBehnke Ina
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22133
Subject(s) - medicine , stent , helicoid , lumen (anatomy) , pulmonary atresia , radiology , surgery , pulmonary artery , geometry , mathematics
Stent implantation in the arterial duct has achieved great acceptance as an alternative to an aortopulmonary shunt procedure. Despite challenging, also tortuous arterial ducts as in ToF and pulmonary atresia with VSD can be addressed, since flexible open cell coronary stents are available. We describe two patients with ToF and Ebstein's anomaly where a special helicoid open cell stent was implanted to cross a highly stenotic sigmoid arterial duct. In both patients, the stent design resulted in extremely kinked stent segments with minor or absent flow through the stent lumen. While in one patient early ToF‐repair was required, in the other recrossing and restenting with another open cell but not helicoid tubular design type of stent allowed adequate pulmonary perfusion. Although mimicking of the natural course even in tortuous ducts is not mandatory, kinking of the stent is likely to occur in these types of arterial ducts. On the basis of our experience, we can not recommend helicoid manufactured stents in the scenario of ductal stenting, especially in congenital heart disease with completely duct dependent pulmonary circulation. © 2009 Wiley‐Liss, Inc.