Does the novel delivery system for the STENTYS self-apposing coronary stent increase the risk of stent edge dissections? Optical coherence tomography post stent findings

Expert Rev Med Devices. 2018 Feb;15(2):157-165. doi: 10.1080/17434440.2018.1421942. Epub 2017 Dec 28.

Abstract

Background: With optical coherence tomography (OCT), details of arterial injuries during percutaneous coronary intervention can be assessed accurately. There might be an increased risk of stent edge dissections with the novel delivery system for the STENTYS stent. We evaluated the prevalence of stent edge dissections using the novel Xposition delivery device as compared with the conventional delivery device.

Methods: A total of 38 patients who were treated with the self-apposing STENTYS stent and with OCT assessment at our center were retrospectively analysed. Twenty patients were treated using the Xposition- and 18 using the conventional delivery device. OCT was performed according to study protocol. Frames with poor quality were excluded.

Results: A total of 12(18%) dissections were detected, 7(20%) in the Xposition delivery device group, and 5(15%) in the conventional group (p = 1). Using the Xposition delivery device 4(33%) dissections were found proximally, using the conventional delivery device 3(25%) (p = ns). Mean longitudinal dissection length was 2.07 ± 1.80mm, 8(67%) appeared as flaps, 4(33%) as cavities. Morphometric parameters were comparable in both groups.

Conclusions: Detailed OCT assessment of stent edge dissections was possible, which revealed no large differences using the Xposition delivery device as compared with conventional delivery device, however large studies are warranted.

Keywords: STENTYS; Self-apposing stent; stent edge dissections.

MeSH terms

  • Aged
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / etiology
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / etiology
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation*
  • Retrospective Studies
  • Risk Factors
  • Stents / adverse effects*
  • Tomography, Optical Coherence*
  • Vascular System Injuries / diagnostic imaging*
  • Vascular System Injuries / etiology