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Related Experiment Videos

Stenting the stent.

Allison C Morton1, Julian Gunn

  • 1Department of Cardiology, Sheffield Teaching Hospitals NHS Trust, United Kingdom.

The Journal of Invasive Cardiology
|July 31, 2002
PubMed
Summary
This summary is machine-generated.

Implanting a second stent within the first (stenting the stent) is a safe and effective strategy when initial stent placement provides insufficient support for resistant lesions. This approach addresses suboptimal outcomes in percutaneous coronary intervention.

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Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Coronary stents possess fixed radial strength, which can be inadequate for certain resistant lesions.
  • Suboptimal stent expansion or support can occur during percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To prospectively evaluate the necessity and safety of implanting a second stent within a previously placed stent.
  • To assess outcomes in patients requiring additional stenting for resistant lesions during the index procedure.

Main Methods:

  • Prospective assessment of 500 consecutive patients undergoing PCI by a single operator (1998-2001).
  • Second stent implantation was performed for angiographically suboptimal lesions after high-pressure balloon/stent expansion.

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  • Exclusion criteria included visible thrombus; clinical follow-up exceeded 1 year.

    • Main Results:

    • A stent-within-a-stent (SWS) strategy was used in 18 patients (3.6%).
    • Reasons for SWS included tissue/stent prolapse (72%), edge dissection (17%), and inflow/outflow issues (5.5%).
    • No acute or in-hospital complications, late thrombosis, or death were observed; target lesion revascularization was 11%.

    Conclusions:

    • Implanting a second stent within a first stent is a safe and effective bailout strategy.
    • This technique provides necessary additional support for challenging coronary lesions.
    • SWs can be successfully employed to manage suboptimal stenting outcomes.