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Mechanical properties of low‐diameter balloon expandable covered stents
Author(s) -
Blais Benjamin,
Carr Karen,
Sinha Sanjay P,
Salem Morris M,
Levi Daniel S
Publication year - 2021
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.29421
Subject(s) - medicine , balloon dilation , dilation (metric space) , stent , balloon , recoil , elastic recoil , nuclear medicine , radiology , surgery , physics , mathematics , combinatorics , quantum mechanics , lung
Objectives To determine over‐dilation potential of commercially available covered stents. Background Covered stents including the Atrium iCast, Gore VBX, and Lifestream stents (LS) can treat ruptures, dissections, and aneurysms in small vessels. Especially in growing patients, stents often require serial dilations beyond their implant or nominal diameters. Tolerance of serial dilations is clinically important information for interventionalists. Methods Serial dilations of 5–12 mm iCast, VBX, and LS covered stents were performed in 1–2 mm increments (up to 20 mm). With each dilation, foreshortening and recoil were measured, and stent strut and covering integrity were assessed. High‐pressure balloons were used to expand the stents until they fractured or could not be further expanded. Results The 5–8 mm LS tolerated dilation to 14.5–16 mm. The 10–12 mm LS stents tolerated dilation to 18 mm and fractured on the 20 mm balloon. LS stents foreshortened 35%–45% on average after 8 mm of over‐dilation and had 5%–10% recoil on <6 mm over‐dilation. All iCast stents tolerated dilation to 12–13 mm and required fracture for dilation to >14 mm. ICast stents foreshortened 19%–29% at maximum dilation, with 3–6% recoil on <2 mm over‐dilation, and < 3% thereafter. VBX stents over‐dilated to 2.9–4.7 mm above nominal, foreshortening 40%–50% after 4–6 mm of over‐dilation before collapsing into a ring. VBX stent recoil was <2.5% on all dilations. Conclusions LS stents had the greatest over‐dilation potential. VBX stents had the least recoil but tended to foreshorten significantly 3–4 mm above nominal. Regardless of nominal size, all iCast stents (including the 5 mm) tolerated dilation to a maximum of 12–13 mm.