Stent deployment within a transesophagostomy orifice to treat a postgastrectomy leak
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ABSTRACT:
SUBMITTER: Rodrigues-Pinto E
PROVIDER: S-EPMC8504039 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Bare Metal Stents (BMS), Drug Eluting Stent (DES) and Exosomes Eluting Stent (EES) were placed in rat abdominal aorta for one week. Then total RNA of aortas was extracted. We used ScienCell's GeneQuery Rat Macrophage Polarization Markers qPCR Array Kit to quantitate gene expression of macrophage relevant genes.
2021-04-30 | GSE155793 | GEO
Project description:PRéCIS:: This case series reports safe, effective implantation of XEN gel stents to treat iridocorneal endothelial (ICE) syndrome. The stents continue to function well and have not been occluded by membranes or peripheral anterior synechiae, but continued follow-up is necessary. PURPOSE:ICE syndrome-related glaucoma is often refractory to medical treatment, and traditional surgical treatment has lower success rates than typical for other types of glaucoma. We present a series of patients who were treated with XEN gel stent implantation. PATIENTS AND METHODS:Retrospective case series of 4 patients with ICE syndrome who underwent XEN with subconjunctival mitomycin C injection. RESULTS:Average preoperative intraocular pressure was 28.5?mm?Hg on 3.8 glaucoma medications, and average postoperative intraocular pressure was 10.5?mm?Hg on 1.0 medication. No patients required return to the operating room for additional procedures over an average of 6.9 months of follow-up. One patient had shallow anterior chamber that resolved with conservative management. Another had shallow anterior chamber that resolved with anterior chamber reformation with viscoelastic and developed nonappositional choroidal effusions that had resolved at most recent follow-up of 7 months after surgery. No XEN implants have been occluded by membrane formation or peripheral anterior synechiae. CONCLUSIONS:XEN is a safe and effective option for surgical management of ICE syndrome-related glaucoma. Further follow-up surveillance is necessary.
| S-EPMC6888868 | biostudies-literature
Project description:Stent thrombosis is a lethal complication of endovascular intervention. Concern has been raised about the inherent risk associated with specific stent designs and drug-eluting coatings, yet clinical and animal support is equivocal.We examined whether drug-eluting coatings are inherently thrombogenic and if the response to these materials was determined to a greater degree by stent design and deployment with custom-built stents. Drug/polymer coatings uniformly reduce rather than increase thrombogenicity relative to matched bare metal counterparts (0.65-fold; P=0.011). Thick-strutted (162 ?m) stents were 1.5-fold more thrombogenic than otherwise identical thin-strutted (81 ?m) devices in ex vivo flow loops (P<0.001), commensurate with 1.6-fold greater thrombus coverage 3 days after implantation in porcine coronary arteries (P=0.004). When bare metal stents were deployed in malapposed or overlapping configurations, thrombogenicity increased compared with apposed, length-matched controls (1.58-fold, P=0.001; and 2.32-fold, P<0.001). The thrombogenicity of polymer-coated stents with thin struts was lowest in all configurations and remained insensitive to incomplete deployment. Computational modeling-based predictions of stent-induced flow derangements correlated with spatial distribution of formed clots.Contrary to popular perception, drug/polymer coatings do not inherently increase acute stent clotting; they reduce thrombosis. However, strut dimensions and positioning relative to the vessel wall are critical factors in modulating stent thrombogenicity. Optimal stent geometries and surfaces, as demonstrated with thin stent struts, help reduce the potential for thrombosis despite complex stent configurations and variability in deployment.
| S-EPMC3131199 | biostudies-literature
Project description:BackgroundVascular stents are small tubular scaffolds used in the treatment of arterial stenosis (narrowing of the vessel). Most vascular stents are metallic and are deployed either by balloon expansion or by self-expansion. A shape memory polymer (SMP) stent may enhance flexibility, compliance, and drug elution compared to its current metallic counterparts. The purpose of this study was to describe the fabrication of a laser-activated SMP stent and demonstrate photothermal expansion of the stent in an in vitro artery model.MethodsA novel SMP stent was fabricated from thermoplastic polyurethane. A solid SMP tube formed by dip coating a stainless steel pin was laser-etched to create the mesh pattern of the finished stent. The stent was crimped over a fiber-optic cylindrical light diffuser coupled to an infrared diode laser. Photothermal actuation of the stent was performed in a water-filled mock artery.ResultsAt a physiological flow rate, the stent did not fully expand at the maximum laser power (8.6 W) due to convective cooling. However, under zero flow, simulating the technique of endovascular flow occlusion, complete laser actuation was achieved in the mock artery at a laser power of ~8 W.ConclusionWe have shown the design and fabrication of an SMP stent and a means of light delivery for photothermal actuation. Though further studies are required to optimize the device and assess thermal tissue damage, photothermal actuation of the SMP stent was demonstrated.
| S-EPMC2211751 | biostudies-literature
Project description:A 79-year-old woman developed a hemothorax 2 days after implantation of a permanent pacemaker. Computed tomography angiography revealed active extravasation from the left internal mammary artery. A covered stent was deployed to manage the arterial perforation. This case report explores different venous access techniques to minimize the risk of arterial injuries and describes the use of a covered stent in managing a non-grafted left internal mammary artery injury from a pacemaker implantation procedure.
| S-EPMC7710994 | biostudies-literature
Project description: Not available
| S-EPMC8544004 | biostudies-literature
Project description:BackgroundCurrent evidence is insufficient to determine the contribution of stent grafts as treatment in partially thrombosed aneurysms or residual wall-adherent thrombi in arteriovenous fistulae (AVFs) for haemodialysis. The overall purpose of this study was to analyse patency rates of post-interventional covered stent deployment in those cases. We also assessed if patency rates differed when fistulas were punctured through the stent during dialysis sessions.MethodsWe conducted a retrospective study between 2006 and 2014 analysing post-intervention primary patency rates using the Kaplan-Meier log-rank test. Multivariate Cox proportional regression models were performed to determine if cannulation within the stent graft area was a potential risk factor for occlusion, by adjusted hazard ratio (HR).ResultsA total of 27 procedures were included in the study. Primary patency rates (%) after stent deployment at 3, 6, 12, 24, 36 and 72 months were, respectively: total 59, 32, 32, 21, 11 and 5; stent puncture 53, 21, 21, 16, 5 and 0; and no stent puncture 80, 80, 80, 40, 40 and 40. Cannulation through the stent graft was not significantly associated with increased risk of obstruction in multivariate analysis (HR = 3.01; P = 0.286).ConclusionStent graft treatment may be a feasible procedure in partially thrombosed aneurysms and residual thrombi in AVF. Although fistulas punctured through the stent presented lower patency rates, this practice was not associated with a higher risk of obstruction. Giving the impossibility of comparing with similar approaches, further studies are needed to confirm or refute the advantages of this procedure.
| S-EPMC7986443 | biostudies-literature
Project description:Stent graft devices for the treatment of abdominal aortic aneurysms (AAAs) are being increasingly used worldwide. Yet, during modelling and optimization of these devices, as well as in clinical practice, vascular sections are idealized, possibly compromising the effectiveness of the intervention. In this study, we challenge the commonly used approximation of the circular cross-section of the aorta and identify the implications of this approximation to the mechanical assessment of stent grafts. Using computed tomography angiography (CTA) data from 258 AAA patients, the lumen of the aneurysmal neck was analysed. The cross-section of the aortic neck was found to be an independent variable, uncorrelated to other geometrical aspects of the region, and its shape was non-circular reaching elliptical ratios as low as 0.77. These results were used to design a finite element analysis (FEA) study for the assessment of a ring stent bundle deployed under a variety of aortic cross-sections. Results showed that the most common clinical approximations of the vascular cross-section can be a source of significant error when calculating the maximum stent strains (underestimated by up to 69%) and radial forces (overestimated by up to 13%). Nevertheless, a less frequently used average approximation was shown to yield satisfactory results (5% and 2% of divergence respectively).
| S-EPMC7070033 | biostudies-literature
Project description:A patient with severe bioprosthesic patient-prosthesis mismatch, severe paravalvular leak, and symptoms of heart failure New York Heart Association functional class III was successfully treated using valve cracking followed by valve-in-valve transcatheter aortic valve implantation with excellent results at 1-year follow-up. (Level of Difficulty: Advanced.).
| S-EPMC8311279 | biostudies-literature
Project description:Drug-coated balloons (DCB) are effective in treating in-stent restenosis (ISR) with neointimal proliferation after bare-metal stent (BMS) implantation, but it is unclear whether DCB are effective in treating BMS-ISR accompanied by thrombosis. An 84-year-old man with previous inferior myocardial infarction and atrial fibrillation developed acute myocardial infarction (AMI) during hospitalization for intracerebral hemorrhage. Emergent coronary angiography (CAG) revealed severe stenosis of the distal left circumflex coronary artery. We implanted a BMS to avoid long-term triple antithrombotic therapy. He received aspirin, clopidogrel, and rivaroxaban for 1 month and then received clopidogrel and rivaroxaban. Seventy days after BMS implantation, he developed AMI, and emergent CAG revealed occlusion of the BMS due to late stent thrombosis. After thrombus aspiration, intravascular ultrasound showed incomplete neointimal healing in the proximal portion of the stent and excessive neointimal proliferation in the distal portion of the stent. DCB angioplasty of the entire BMS was performed after scoring balloon pre-dilation. Seven months after BMS implantation, follow-up CAG revealed binary ISR. DCB angioplasty of the entire BMS was performed again after scoring balloon pre-dilation. Thirteen months after BMS implantation, follow-up CAG did not reveal recurrence of ISR. <Learning objective: Drug-coated balloons (DCB) were ineffective when there was excessive neointimal proliferation accompanied by thrombosis, but effective in binary in-stent restenosis (ISR). DCB may be ineffective in early ISR after bare-metal stent implantations and when there is excessive neointimal proliferation accompanied by thrombosis. Since the safety and efficacy of DCB to treat excessive neointimal proliferation occurring with late stent thrombosis is unclear, further studies are needed.>.
| S-EPMC6718827 | biostudies-other