دورية أكاديمية
أعرض في EDS

Early and intermediate-term complications of self-expanding stents limit its potential application in children with congenital heart disease.

التفاصيل البيبلوغرافية
العنوان: Early and intermediate-term complications of self-expanding stents limit its potential application in children with congenital heart disease.
المؤلفون: Cheung YF; Grantham Hospital, Department of Pediatrics, University of Hong Kong, Aberdeen., Sanatani S, Leung MP, Human DG, Chau AK, Culham JA
المصدر: Journal of the American College of Cardiology [J Am Coll Cardiol] 2000 Mar 15; Vol. 35 (4), pp. 1007-15.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Print ISSN: 0735-1097 (Print) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
مواضيع طبية MeSH: Stents*, Angioplasty, Balloon/*instrumentation , Heart Defects, Congenital/*therapy, Adolescent ; Angiography ; Child ; Child, Preschool ; Constriction, Pathologic/diagnostic imaging ; Constriction, Pathologic/therapy ; Equipment Failure Analysis ; Female ; Follow-Up Studies ; Heart Defects, Congenital/diagnostic imaging ; Hemodynamics/physiology ; Humans ; Male ; Prosthesis Design ; Pulmonary Artery/abnormalities ; Pulmonary Artery/diagnostic imaging ; Pulmonary Veno-Occlusive Disease/diagnostic imaging ; Pulmonary Veno-Occlusive Disease/therapy ; Retreatment ; Treatment Outcome
مستخلص: Objectives: We report on the early and intermediate-term follow-up results of self-expanding Wallstent (Schneider, Switzerland) implanted in children with congenital heart disease.
Background: The inherent shortcomings of balloon-expandable stents prompted the trial of an alternative stent.
Methods: Twenty patients underwent 22 implantations of 25 self-expanding Wallstents between December 1993 and June 1997 in two institutions. The mean age and weight were 10.8+/-4.5 years and 30.5+/-14.2 kg, respectively. The patients were divided into two groups: 1) Group I comprised 17 patients with pulmonary arterial stenoses, 2) Group II comprised four patients with venous stenoses (one belonged to both groups). Sixteen patients underwent recatheterization at a median of 5.8 months (range 0.5 to 31, mean 8.1 months) after stenting. Hemodynamic and angiographic changes after the interventional procedures and complications were documented.
Results: All the stents were successfully deployed in the intended position. In Group I, the narrowest diameter of the stented vessel increased from 4.1+/-1.5 to 8+/-2 mm (95% increase, p < 0.0001) while the systolic pressure gradient across decreased from 24.6+/-15.8 to 12.1+/-11.4 mm Hg (51% decrease, p = 0.001). In Group II, the dimensional changes of the narrowest segment increased from 4.3+/-0.5 to 7.5+/-0.4 mm (75% increase, p = 0.003), and the pressure gradient reduced from 5.0+/-2.9 to 0.9+/-1.0 mm Hg (82% decrease, p = 0.04) across the stented venous channel. Distal migration of two optimally positioned stents occurred within 24 h of implantation. At recatheterization, significant neointimal ingrowth (>30% of the expanded diameter) was noted in 7 (28%) of the 25 implanted stents. This responded poorly to balloon dilation. Predisposing factors for the neointimal ingrowth included stents of smaller diameter (<9 mm) and longer period after implantation.
Conclusions: Self-expanding Wallstent could be deployed easily and safely to relieve vascular stenoses in children. The complications of distal migration, significant neointimal ingrowth and its unyielding design to overdilation limit its application to this patient group.
تواريخ الأحداث: Date Created: 20000325 Date Completed: 20000331 Latest Revision: 20190708
رمز التحديث: 20240829
DOI: 10.1016/s0735-1097(99)00644-0
PMID: 10732902
قاعدة البيانات: MEDLINE
الوصف
تدمد:0735-1097
DOI:10.1016/s0735-1097(99)00644-0