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THE UNIVERSAL ANASTOMOTIC STENT – A NOVEL PROXIMAL CORONARY ARTERY BYPASS ANASTOMOTIC DEVICE
Author(s) -
Harden M. P.,
Sims A.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04115_7.x
Subject(s) - medicine , anastomosis , stent , intimal hyperplasia , surgery , neointimal hyperplasia , vein , artery , radiology , restenosis , smooth muscle
Purpose Proximal anastomotic devices have been developed to produce predictable results that eliminate surgical technique as a variable with respect to the anastomosis, improve graft patency and lower the incidence of stroke. One criticism of current devices is foreign material contact at the anastomosis which is thought to stimulate intimal hyperplasia and thrombosis. In co‐operation with AllVascular Restorative Vascular Solutions, an anastomotic device for use in vein graft‐aortic anastomosis, the Universal Anastomotic Stent (UAS), was developed to eliminate foreign body contact with blood. Methodology The design concept for the UAS was based on the Venous Valve Transfer stent developed by AllVascular. This stent is designed to transfer a functional venous valve to a vein with valve incompetence as a treatment of venous valve insufficiency. The UAS prototype developed from this stent underwent pre‐clinical testing in sheep for design review. Results Animal trials established that an external nitinol expanding stent can be used to create an arterial anastomosis. Loading a vein graft onto the UAS proved difficult in the absence of a crimping tool. A design concept for a dedicated loading tool has been developed and an animal model for future testing was finalised. Conclusions The UAS, compared to existing anastomotic devices, has the advantage of maintaining intima‐intima contact at the anastomosis, which may reduce the inflammatory response. External stenting may limit compliance mismatch at the anastomosis and reduce intimal hyperplasia. Further animal testing is required to establish if this novel anastomotic device will be suitable for human use.